Sublingual misoprostol after surgical management of early termination of pregnancy

Abstract

Objective: To assess the efficacy of sublingual misoprostol after surgical management of early termination of pregnancy (ETP) regarding duration and amount of bleeding, presence of retained products of conception (RPOC), and endometrial thickness.

Design: Prospective, randomized clinical trial.

Setting: University hospital.

Patient(s): One hundred five patients admitted for possible management of early pregnancy failure and unwanted pregnancy.

Intervention(s): Manual vacuum aspiration (control and study groups) plus 400 microg sublingual misoprostol (study group) at pregnancy termination, and transvaginal ultrasonography (both groups) 10 days after the procedure.

Main outcome measure(s): Duration and amount of bleeding and presence of RPOC and endometrial thickness 10 days after the procedure.

Result(s): Bleeding lasted 3.2 and 5.1 days in the study and control groups. Severe vaginal bleeding occurred in two patients in the study group and in six patients in the control group. Mean endometrial thickness was 5.5 mm in the study group and 6.9 mm in the control group. These differences were statistically significant. No cases of RPOC occurred in the study group; two cases occurred in the control group.

Conclusion(s): In countries in which surgical management of ETP is still done, using sublingual misoprostol postoperatively may reduce the duration and amount of bleeding.