Intravaginal misoprostol for medical management of missed abortions up to twenty weeks of gestation

Introduction: Missed abortion is a type of abortion in which the dead fetus is retained within the uterus. The objective of the study was to find out whether the use of one or two doses of 800 µg misoprostol alone, administered intra-vaginally, is effective and safe in termination of missed abortion up to 20 weeks of pregnancy. Materials and Methods: This Interventional study was conducted in a tertiary care hospital, for a period of 12 months. Sample size consisted of 67 cases of missed abortion up to 20 weeks of pregnancy which was confirmed by ultrasound. These patients were given 800µg misoprostol and were followed up for successful termination of pregnancy and side effects, viz., pain, excessive bleeding, need for surgical evacuation, rupture uterus and infection. If complete abortion had not been attained by a single dose, a repeat dose of 800µg vaginal misoprostol was inserted. Results: In the present study, 88.06% patients aborted completely after giving misoprostol alone; where as 72.9% patients requiring only single dose of misoprostol. The success rate decreased with increasing parity and number of previous abortions in patients and results were found statistically significant (p = 0.008 and 0.035 respectively). Side effects were tolerable and required only proper counseling. Conclusion: Misoprostol alone is a safe and effective method of termination of missed abortion up to 20 weeks of gestation; and will prove to be a good alternative to surgical management. Keywords: Missed abortion, Misoprostol, Intra-vaginally, Termination of pregnancy, 20 weeks gestation, Surgical evacuation.