Safety, Efficacy and Acceptability of Oral misoprostol in the Management of Incomplete Abortion:–A Prospective Observational Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 7
Abstract
To investigate the safety, efficacy, and acceptability of oral misoprostol of different doses for treatment of incomplete abortion according to the uterine size. A prospective observational study. Chittagong Medical College Hospital, Surgiscope Hospital Private Limited,Adhunik Hospital Private limited. March 2015-July 2017. Two hundred ten women with a clinical diagnosis ofincomplete abortion and a uterine size <14 weeks. A total of 210 women were randomized selected for the study, after clinical examination and proper counseling due to excessive bleeding (32patient) and 23 patient were disagreedue to other reasons to take the misoprostol, so 55 patient were excluded from the study and then 155 patient wererecruited for this study takeeither a singledose of 600 micrograms of oral misoprostol or multiple dose of misoprostol 600microgram 3 hourly for three times in a single day. After clinical diagnosisof incomplete abortion either spontaneous or induced, was confirmed by ultrasonography. single dose regimen were adopted when uterine height was less than 10 weeks and multiple dose were adopted when uterine height were within 10 -14 weeks. All the patient were treated as outdoor patient with oral antibiotic for 7 days, clinically assessed for completion and some need ultrasonography at 7-day follow up. If it was still incomplete, very minute amount of product of conception, then woman was offered for expectant management with oral contraceptives pill. During next period it was completely flushed out. Most of the time it was confirmed by ultrasonography of an additional 1-month follows up. Success rate was very high in both arms: single dose of misoprostol is 82.85% and failure rate -17.14%, in multiple dose success rate is 82.70%, and failure rate is 15.29%. Difference arenot so significant in both dose schedule. Most adverse effects were pain, although the mean pain score was almost same. Another complication was also observed that 22.31 % patient were suffering from slight irregular per vaginal bleeding since complete evacuation.All the womenwere very satisfied with misoprostol either of the dose and a higher proportion of women in the misoprostol treatment said that they would recommend the treatment to a friend (85% versus 70%, P < 0.001). Misoprostol is an effective drug for the treatment of incomplete abortion at uterine size of <14 weeks. The acceptabilityof misoprostol appears higher. There are so many practicaladvantages of misoprostol in low-resource settings like Bangladesh misoprostol should be more widely available for treatment ofincomplete abortion in the developing country.
Authors and Affiliations
Dr. Shahana Begum, Dr. Md Tipu Sultan, Dr. Nur Jahan Begum, Dr. Rowshan Ara Begum, Dr. Sarwar Are
Keywords
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