[The use of a synthetic analog of prostaglandin E1 for medical treatment of first trimester pregnancy failure].
First trimester failure is a common event accruing in 15-20% of pregnancies that has traditionally been treated by surgical curettage. An alternate therapy is medical treatment using misoprostol, a synthetic analog of prostaglandin E1. Numerous studies have been carried out comparing treatment by misoprostol with a placebo. They have found a significant advantage to misoprostol mode of treatment. Other studies comparing surgical and medical treatment found the surgical treatment to be superior to the latter. It must be noted that the medical mode of treatment was indeed found to be successful in over 80% of cases. No significant differences were noted in the complication rates of the two groups. Misoprostol therapy has been found to be effective when administered orally or vaginally, although vaginal therapy is slightly superior. No large scale studies have been carried out to date testing the safety of this treatment in patients with a scarred uterus (due to Cesarean section or hysterotomy). However, on the basis of reported facts, it seems plausibLe to suggest misoprostoL treatment for these patients.
Department of Obstetrics and Gynecology, Kaplan Medical Center, Rechovot, Hadassah Medical School, Hebrew University, Jerusalem, Israel. houminer@yahoo.com
Aryeh
A
Houminer
Gideon
G
Kopernic
Zion
Z
Hagay
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000028:Abortion, Induced / Q000379:methods*; D000527:Alprostadil / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011261:Pregnancy Trimester, First; D014599:Uterus / Q000473:pathology
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; D000527:Alprostadil