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GYN: Misoprostol for Incomplete MiscarriageFrom: art fougner, md (evsono@pipeline.com)Mon May 3 06:56:10 2004
Two Regimens of Misoprostol for Treatment of Incomplete Abortion Kelly Blanchard, MSc*, Surasak Taneepanichskul, MD, MPH, Orawan Kiriwat, MD, Korakot Sirimai, MD, Nucharee Svirirojana, MSc*, Nqobile Mavimbela* and Beverly Winikoff, MD, MPH* >From the *Population Council, Johannesburg, South Africa; Bangkok, Thailand; and New York, New York; the Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn Hospital, Chulalongkorn University, Bangkok, Thailand; and the Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. Address reprint requests to: Kelly Blanchard, P.O. Box 1985, Parklands 2121, South Africa; e-mail: kblanchard@ibisreproductivehealth.org. OBJECTIVES: Misoprostol shows promise for treatment of incomplete abortion. We evaluated 2 simple misoprostol regimens to estimate whether they were effective in treating incomplete abortion. METHODS: A total of 169 women was randomly assigned to either a single or double dose of 600 µg misoprostol. The women, who would have received a surgical evacuation of the uterus for incomplete abortion, were patients at 2 hospitals in Bangkok, Thailand. The 2 groups of women were compared for success of treatment (no need for surgical evacuation), side effects, and acceptability. RESULTS: Sixty-six percent of women in the single-dose group and 70% of women in the double-dose group had complete abortions with misoprostol. More than 90% of women in the single- and double-dose groups reported that the side effects were tolerable; frequency of side effects was similar between the 2 groups. Women found the treatment acceptable. Approximately 90% of women in both groups would recommend the treatment to a friend. Acceptability and efficacy were different at the 2 participating clinics. CONCLUSION: Misoprostol is an effective treatment for incomplete abortion. Simple regimens may be as effective as more complicated ones and a single dose of 600 µg should be further evaluated in larger trials. LEVEL OF EVIDENCE: I Obstetrics & Gynecology 2004;103:860-865
-- art fougner, md ich bin ein New Yorker
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