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Saudi Med J. 2009 Jan;30(1):82-7.

Comparison of oral and vaginal misoprostol for cervical ripening before evacuation of first trimester missed miscarriage.

Author information

  • 1Department Head of Obstetrics and Gynecology, Baghdad Teaching Hospital, Medical City Health Directorate, PO Box 19119, Baghdad, Iraq. maysoonjabir@yahoo.com.

Abstract

OBJECTIVE:

To assess the effectiveness of misoprostol in cervical ripening before evacuation of conception in the first trimester missed miscarriages, and to compare between oral and vaginal routes of administration.

METHODS:

A randomized controlled study was carried out in Baghdad Teaching Hospital, Baghdad, Iraq in 2006. One hundred and twenty women with first trimester missed miscarriages were divided into 2 study groups, randomized for oral and vaginal 400 mcg misoprostol priming of cervix, and 2 control groups randomized for oral and vaginal placebo, before undergoing surgical evacuation of conception after 3 hours. Measured outcomes were: post medication cervical dilatation, time needed to dilate the cervix surgically, blood loss, and development of the side effects of misoprostol.

RESULTS:

Post medication cervical dilatation was higher in the misoprostol group (7.07 +/- 1.36 mm for oral misoprostol, 7.77 +/-1.22 mm for vaginal misoprostol), versus the control groups (2.43 +/- 0.5 mm). Post medication cervical dilatation was significantly higher in the vaginal misoprostol group, compared to the oral group (p=0.04). The time required to dilate the cervix in the misoprostol group was shorter, compared with placebo. There were no significant differences in the amount of blood loss between oral (p=0.74), and vaginal misoprostol groups (p=0.62), and gastrointestinal side effects were significantly more in the oral misoprostol group (p=0.014).

CONCLUSION:

Misoprostol is an effective cervical priming agent when administered either orally or vaginally before evacuation of conception in the termination of the first trimester missed miscarriage.

PMID:
19139779
[PubMed - indexed for MEDLINE]
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