Study Comparing Between Surgical Evacuation and Medical Management with Vaginal Misoprostol for Early Pregnancy Loss

Authors

  • Sadia Rahman Senior Consultant,Gynae & Obs, 250 beded Naogaon General Hospital, Naogaon
  • Rabeya Parvin Assistant Professor, Gynae & Obs, Shaheed Suhrawardy Medical College (ShSMC), Dhaka
  • Most Nur A Sharmin Junior Consultant, Gynae & Obs, Sadar Hospital, Narsingdi
  • Md Nazmul Arefin Junior Consultant, Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka
  • Md Ashraful Islam Medical Officer, Bangabandhu Sheikh Mujib Medical University, Dhaka
  • Zillur Rahman Junior Consultant, Surgery 250 beded Mohammed Ali hospital, Bogura
  • Md Aziz Ullah Assistant Professor, Surgery, Cumilla Medical College, Cumilla
  • Md Aminul Islam Assistant Professor, Surgery, Cumilla Medical College, Cumilla
  • Afsana Begum Assistant Professor, Mugda Medical College, Dhaka

DOI:

https://doi.org/10.3329/bccj.v11i1.66051

Keywords:

Early pregnancy loss, misprostol, surgical evacuation

Abstract

Background: Early pregnancy loss is one of the most common clinical problems that is encountered in daily
gynaecological practice. The aim of this study is to assess the effectiveness and acceptability of using vaginal
misoprostol for management of first trimester spontaneous incomplete abortion as an alternative to direct vaginal
surgical evacuation in our setting.

Methods: This prospective randomized study was carried out in the Department of Obstetrics and Gynaecology in
Shaheed Ziaur Rahman Medical College Hospital, Bogra. from January 2008 to December 2008. This study performed
on 400 patients with first trimester incomplete abortion between 8 and 12 weeks requesting medical management. They
were divided into two groups according to patients’ choice; group (I) received 800 microgram misprostol vaginally by
digital insertion into the posterior fornix while group (II) underwent surgical vaginal evacuation directly under general
anesthesia.

Results: Although vaginal surgical evacuation was successful in solving the problem in 100% of cases, misoprostol was
successful in 70% after 1st dose and remained incomplete 30% after administration of 2nd dose. The overall satisfaction
was slightly higher in the surgical group. No serious side effects or complications were reported in the misoprostol
group. The incidence of excessive post-abortive bleeding was more in the misoprostol group than in the surgical
evacuation group (p = 0.049).

Conclusion: Although vaginal surgical evacuation is more effective than misoprostol in solving the problem still
medical treatment is effective and acceptable especially when surgical management is not available or risky or patients
refuse to do surgical management.

Bangladesh Crit Care J March 2023; 11 (1): 19-23

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Published

2023-05-21

How to Cite

Rahman, S. ., Parvin, R. ., Sharmin, M. N. A. ., Arefin, M. N. ., Islam, M. A. ., Rahman, Z. ., Ullah, M. A. ., Islam, M. A. ., & Begum, A. . (2023). Study Comparing Between Surgical Evacuation and Medical Management with Vaginal Misoprostol for Early Pregnancy Loss. Bangladesh Critical Care Journal, 11(1), 19–23. https://doi.org/10.3329/bccj.v11i1.66051

Issue

Vol. 11 No. 1 (2023)

Section

Original Articles

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