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A Comparison of Vaginal Misoprostol 800 mg Versus 400 mg in Early Pregnancy Failure: A Randomized Controlled Trial


Chalisa Prasartsakulchai MD*,
Yuen Tannirandorn MD*

* Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University


Aim : To compare the efficacy, side effects and patient satisfaction between 800 mg versus 400 mg intravaginal misoprostol for early pregnancy failure.
Material and Method : Women diagnosed as early pregnancy failure were randomly assigned to receive either 800 mg or 400 mg intravaginal misoprostol. The second dose was administered if there was no evidence of abortion in 24 h. The treatment failure was reffered to no complete abortion within 48 h. Dilatation and curettage was performed if the patients had heavy vaginal bleeding or evidence of incomplete abortion or no complete abortion.
Results : 25 patients were randomized to receive 800 mg and 25 patients were to receive 400 mg misoprostol. Complete abortion was not significantly different between the 2 groups (72%, 76% respectively). Although median time to abortion in the 800 mg group was significantly shorter, the patients experienced more side effects especially fever which was significantly different (P = 0.04). In the 800 mg group, 2 patients had heavy vaginal bleeding and one patient developed endometritis. There was no significant difference in the patientsí satisfaction between both groups.
Conclusions : 400 mg of vaginal misoprostol are as effective as 800 mg in producing complete abortion in early pregnancy failure with less side effects and similar patient satisfaction.

Keyword : Early pregnancy failure, First trimester, Misoprostol, Pregnancy termination

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