Medical treatment of the complication of first trimester pregnancy loss with misoprostol

The objective of the study was to evaluate the efficacy of misoprostol in patients with complication of first trimester pregnancy loss. After the departmental approval, a total of 102 women with first trimester pregnancy failure were recruited for treatment with misoprostol. The inclusion criteria were gestational age of less than 12 weeks and hemodynamically stable. The exclusion criteria were patients with history of hypersensitivity to prostaglandin, bronchial asthma and hemoglobin less than 9 g. Main outcome measures were the successful resolution of miscarriages without surgical intervention; secondary outcomes were incidence of pain, vaginal bleeding, infection, pyrexia and gastrointestinal side effects. A total of 102 women were included in the study. Age ranged from 16 to 40 years and parity ranged from 0 to grand multipara. Women were not selected according to parity but parity was a random occurrence. No relationship was found between parity and response to treatment with misoprostol. Incomplete abortion was found in 82 (80.39%), an embryonic pregnancy in 7 (6.86%) and early fetal demise in 13 (12.74%). 62.74% women completely expelled the conceptual products on treatment with misoprostol alone, while 38 (37.25%) patients required surgical evacuation due to incomplete expulsion of conceptual products. Mean induction to expulsion interval was 15.66 h. Main side effects noted were pain, pyrexia, nausea, vomiting and diarrhea. More than one side effect was noted in 7 (22.54%) patients. Treatment of early pregnancy loss with misoprostol is efficient, acceptable and cost effective for patients with complications of first trimester pregnancy loss.