title: Misoprostol to treat missed abortion in the first trimester.
abstract: Missed abortion in the first trimester is characterized by the arrest of embryonic or fetal development. The cervix is closed and there is no or only slight bleeding. Ultrasound examination shows an empty gestational sac or an embryo/fetus without cardiac activity. Based on a review of the published literature a single dose of 800 microg vaginal misoprostol may be offered as an effective, safe, and acceptable alternative to the traditional surgical treatment for this indication. Alternatively, 600 microg misoprostol can be administered sublingually. After administration of misoprostol, hospitalization is not necessary and the time to expulsion varies considerably. Bleeding may last for more than 14 days with additional days of light bleeding or spotting. The woman should be advised to contact a provider in case of heavy bleeding or signs of infection. A follow-up is recommended after 1 to 2 weeks.
authors.affiliation: Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet/Karolinska University Hospital, Stockholm, Sweden. Kristina.gemzell@kbh.ki.se
authors.forename: K
authors.initials: K
authors.lastname: Gemzell-Danielsson
authors.forename: P C
authors.initials: PC
authors.lastname: Ho
authors.forename: R
authors.initials: R
authors.lastname: Gómez Ponce de León
authors.forename: A
authors.initials: A
authors.lastname: Weeks
authors.forename: B
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects; D000030:Abortion, Missed / Q000188:drug therapy*; D000282:Administration, Intravaginal; D000286:Administration, Sublingual; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol