Paper Information

Journal:   INTERNATIONAL JOURNAL OF REPRODUCTIVE BIOMEDICINE (IRANIAN JOURNAL OF REPRODUCTIVE MEDICINE)   October 2016 , Volume 14 , Number 10; Page(s) 643 To 648.
 
Paper: 

Intra uterine extra-amniotic versus vaginal misoprostol for termination of second trimester miscarriage: A randomized controlled trial

 
 
Author(s):  Abbas Mitwaly Abo Bakr, Abbas Ahmed Mohamed*, Sayed Abdellah Mohamed
 
* Department of Obstetrics and Gynecology, Assiut University, Egypt Woman’s Health Hospital, 71511, Assiut, Egypt
 
Abstract: 
Background: Termination of pregnancy in the second trimester using prostaglandins has been shown to be safe and effective. Misoprostol has multiple routes of administration; oral, vaginal, buccal, rectal and sublingual. Objective: The study aims to compare the efficacy and safety of intrauterine extra-amniotic and vaginal misoprostol in a dose of 200 microgram every 4 hours for the termination of pregnancy in cases of second trimester miscarriage. Materials and Methods: A prospective randomized open labeled clinical trial included 180 women with missed miscarriage in gestational age between 13 and 24 wks. Patients were randomized to receive subsequent doses of 200 μ g misoprostol every 4 hrs either intra uterine extra-amniotic by Foley catheter or vaginally administered. Randomization was completed using a computer-generated random table. The primary outcome of this study was the mean duration from the initial misoprostol dose until complete fetal expulsion (induction-expulsion interval). Results: The mean gestational age was 17. 74 wks. The mean time to complete miscarriage in the intra uterine extra-amniotic group was 5. 27 hrs, which was significantly lower than the vaginal group (9. 92 hrs, p=0. 001). Side effects were more common in vaginal group. Conclusion: Intra uterine extra-amniotic misoprostol with a dose of 200 μ g every 4 hrs appears to be more effective and safer than vaginal misoprostol in induction of second trimester miscarriage.
 
Keyword(s): Misoprostol,Missed miscarriage,Termination of pregnancy,Prostaglandins
 
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