Misoprostol for treatment of early pregnancy failure in women with previous uterine surgery.
OBJECTIVE
Misoprostol use in early pregnancy may incur a risk of uterine rupture in women with previous uterine surgery.


METHODS
We analyzed 488 women who received misoprostol 800 microg vaginally in a study that evaluated medical and surgical management of early pregnancy failure. Subjects received a repeat misoprostol dose if expulsion was not confirmed 2 days after treatment. We compared efficacy, acceptability, and safety in subjects with a history (n = 78 women) or absence (n = 410 women) of uterine surgery, defined as cesarean delivery or myomectomy.


RESULTS
Expulsion rates after a single misoprostol dose (69% vs 72%; P = .64) and overall success at 30 days (82% vs 85%; P = .50) were comparable. Pain, bleeding, complications, and acceptability did not differ. No uterine ruptures occurred (95% CI, 0, 3.8%).


CONCLUSIONS
Misoprostol treatment for early pregnancy failure had similar success, acceptability, and complications in women with and without previous uterine surgery.
Chen
Beatrice A
BA
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, and Magee-Womens Research Institute, Pittsburgh, PA, USA.
Reeves
Matthew F
MF
Creinin
Mitchell D
MD
Gilles
Jerry M
JM
Barnhart
Kurt
K
Westhoff
Carolyn
C
Zhang
Jun
J
D000282:Administration, Intravaginal; D000328:Adult; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000494:pharmacology* / Q000627:therapeutic use; D010120:Oxytocics / Q000494:pharmacology* / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D014597:Uterine Rupture / Q000139:chemically induced*; D014599:Uterus / Q000187:drug effects* / Q000601:surgery*
D010120:Oxytocics; D016595:Misoprostol