Vaginal versus oral misoprostol in the management of first trimester missed abortion among admitted patients in a tertiary level hospital

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dc.contributor.authorAbid, Taslimaen_US
dc.contributor.authorSultana, Surovien_US
dc.contributor.authorKhatun, Nofisaen_US
dc.contributor.authorKulsum, Ummeen_US
dc.contributor.authorRumpa, Farhana Yesminen_US
dc.date.accessioned2025-08-13T08:32:59Z
dc.date.available2025-08-13T08:32:59Z
dc.date.issued2025-04
dc.description.abstractBackground: Missed abortion is a common first-trimester pregnancy complication requiring effective medical management. Misoprostol, a prostaglandin E1 analog, is widely used through oral or vaginal administration. However, the comparative efficacy, required doses, expulsion time, and side-effect profile between these two routes remain subjects of ongoing research, particularly in low-resource settings like Bangladesh. Objective: The objective of the study was to compare the efficacy, required doses, time to expulsion, side effects, and cervical permeability between oral and vaginal misoprostol in the management of first-trimester missed abortion. Methods: This randomized controlled trial was conducted in a tertiary-level hospital in Bangladesh, involving 118 women diagnosed with first-trimester missed abortion. Participants were randomly assigned to receive either oral misoprostol (Group A, n = 59) or vaginal misoprostol (Group B, n = 59). Primary outcomes included complete expulsion rates, time to expulsion, number of doses required, and side effects. Statistical analysis was performed using Pearson’s Chi-square test for categorical data and independent t-tests for continuous variables, with significance set at P < 0.05. Results: Vaginal misoprostol demonstrated significantly higher complete expulsion rates (76.27% vs. 37.29%, P < 0.001), required fewer doses (mean: 1.69 vs. 2.41, P < 0.001), and had a shorter time to expulsion (7.69 ± 2.89 vs. 9.45 ± 1.40 h, P = 0.032) compared to oral misoprostol. Nausea and vomiting were more frequent with oral misoprostol, but other side effects were comparable. Cervical permeability among unsuccessful cases did not differ significantly between groups (P = 0.6985). Conclusion: Vaginal misoprostol is more effective than oral administration, offering higher expulsion rates, faster expulsion, and requiring fewer doses, with a similar safety profile. These findings support vaginal misoprostol as the preferred route for the medical management of first-trimester missed abortion. Future research should explore sublingual routes, adjunctive mifepristone therapy, and patient-centered factors to further optimize treatment strategies.en_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynaecology, Sariakandi Upazila Health Complex, Bogura, Bangladeshen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynaecology, Upazila Health Complex, Sunderganj, Gaibandha, Bangladeshen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynaecology, Dhupchanchia Upazilla Health Complex, Bogura, Bangladeshen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynaecology, Ullapara Upazila Health Complex, Sirajganj, Bangladeshen_US
dc.identifier.affiliationsDepartment of Obstetrics and Gynaecology, Upazila Health Complex, Adamdighi, Bogura, Bangladeshen_US
dc.identifier.citationAbid Taslima, Sultana Surovi, Khatun Nofisa, Kulsum Umme, Rumpa Farhana Yesmin . Vaginal versus oral misoprostol in the management of first trimester missed abortion among admitted patients in a tertiary level hospital. Annals of International Medical and Dental Research. 2025 Apr; 11(2): 35-42en_US
dc.identifier.issn2395-2822
dc.identifier.issn2395-2814
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/250004
dc.languageenen_US
dc.publisherScholars Publisheren_US
dc.relation.issuenumber2en_US
dc.relation.volume11en_US
dc.source.urihttps://aimdrjournal.com/wp-content/uploads/2025/05/01_AIMDR_2_Karimul_Issue_2_2025.pdf#01_AIMDR_2_Karimul_Issue_2_2025.indd::0en_US
dc.subjectMisoprostolen_US
dc.subjectmissed abortionen_US
dc.subjectvaginal administrationen_US
dc.subjectoral administrationen_US
dc.subjectmedical abortionen_US
dc.subjectexpulsion rate.en_US
dc.titleVaginal versus oral misoprostol in the management of first trimester missed abortion among admitted patients in a tertiary level hospitalen_US
dc.typeJournal Articleen_US
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