Comparison of side effects: “Vaginal versus oral misoprostol in the management of the first-trimester missed abortion”
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Date
2025-02
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Abstract
Introduction: In recent years, the use of oral or vaginal misoprostol has grown in popularity. The therapeutic potential of misoprostol as an abortifacient has clearly been demonstrated in a randomized study. Misoprostol is active and safe both by oral and vaginal routes but the latter has been found to be better in many trials. Aim of the Study: Aim of the objective is to compare the efficacy and safety of vaginal misoprostol to oral misoprostol for the treatment of first-trimester missed abortion. Methods: The study was conducted in the Gynaecology and Obstetrics Department of Shaheed Ziaur Rahman Medical College Hospital in Bogra over a period of 6 months, from May 2015 to October 2015. The participants included women diagnosed with miscarriage, based on both their medical history and physical examinations, and referred from the outpatient department for admission. The diagnosis of missed miscarriage was confirmed by sonography. Only women who met the specified inclusion and exclusion criteria were enrolled, leading to a total sample size of 118 participants, divided into two groups of 59 each. Results: In both groups most of the respondents were in the “20–25 years” age group; out of the 59 respondents each in groups, 33.9% of Group A and 42.4% of Group B were in the age group. Mean ± standard deviation (SD) of age was calculated to be, (24.60 ± 3.049) for Group A and Group B (23.98 ± 2.387). Both groups had a similar type of distribution of the length of menstrual cycle. Out of the 118 respondents, only 11 (9.3%) had a previous miscarriage. 89.8% of Group A and 91.5% of Group B had not experienced abortion before. About two-fifths of the respondents in both groups (42.4% Group A and 37.3% Group B) were primigravidae. Among 2nd gravidae Group B (18) were double in count to Group A (9). Mean ± SD was calculated for Group A (1.81 ± 1.004) and Group B (1.78 ± 1.018). About 10.9 weeks was the average period of gestation for both groups. Both Group A and Group B had similar types of distribution. More than three-fourths of group B (45 [76.3%]) had successfully achieved complete expulsion of the conceptus; while in group A less than half of that (22 [37.3%]) had complete expulsion. Incomplete expulsion accounted to be 2½ times higher in Group A and “No expulsion” was 4 times as high as Group B. Conclusion: Per vaginal administration of Misoprostol in the posterior fornix is more effective than Oral Misoprostol. The former has a faster onset of action and better efficacy. Per vaginal Misoprostol has less side effects.
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Keywords
Misoprostol, missed abortion, sonography.
Citation
Abid Taslima, Sultana Surovi, Khatun Nofisa, Kulsum Umme, Rumpa Farhana Yesmin . Comparison of side effects: “Vaginal versus oral misoprostol in the management of the first-trimester missed abortion”. Annals of International Medical and Dental Research. 2025 Feb; 11(1): 1-7