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Am J Obstet Gynecol. 2007 Jan;196(1):31.e1-7.

Bleeding patterns after misoprostol vs surgical treatment of early pregnancy failure: results from a randomized trial.

Author information

  • 1Columbia University, Department of Obstetrics & Gynecology, 622 West 168th St, PH 16 Room 80, New York, NY 10032, USA. ard4@columbia.edu

Abstract

OBJECTIVE:

The purpose of this study was to describe bleeding patterns after misoprostol or curettage for early pregnancy failure (EPF).

STUDY DESIGN:

This was a randomized trial that included women (n = 652) with EPF. Participants were assigned to vaginal misoprostol (800 microg) or curettage in a 3:1 ratio. Participants completed a bleeding diary. We measured hemoglobin levels at baseline and 2 weeks after the treatment.

RESULTS:

Decreases in hemoglobin levels were greater after misoprostol (-0.7 g/dL; SD, 1.2) than curettage (-0.2 g/dL; SD, 0.9; P < .001). Large changes in hemoglobin levels (at least 2 g/dL) or low nadir hemoglobin levels (< 10 g/dL) were more frequent after misoprostol (55/428 women; 12.8%) than after curettage (6/135 women; 4.4%; P = .02). More participants in the misoprostol group reported "any bleeding" or "heavy bleeding" every study day. Four women who were treated with misoprostol required blood transfusion.

CONCLUSION:

Bleeding is heavier and more prolonged after medical treatment with misoprostol than with curettage for EPF; however, bleeding rarely requires intervention.

PMID:
17240222
[PubMed - indexed for MEDLINE]
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