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. 2019 Dec;69(6):501-508.
doi: 10.1007/s13224-019-01247-x. Epub 2019 Jun 26.

Home-Based Extended Low-Dose Oral Misoprostol in Management of First-Trimester Pregnancy Loss in Low-Resource Communities: A Randomized Trial

Ayman H Shaamash  1 , E A Khlifah  1 , A M Esmail  1 , Sh G Abdelmonem  2
Affiliations

Home-Based Extended Low-Dose Oral Misoprostol in Management of First-Trimester Pregnancy Loss in Low-Resource Communities: A Randomized Trial

Ayman H Shaamash et al. J Obstet Gynaecol India. 2019 Dec.

Abstract

Objective: To investigate the efficacy, safety and tolerability of a home-based extended low-dose oral misoprostol for management of first-trimester pregnancy loss.

Materials and methods: A randomized trial that was conducted in the Woman's Health University Hospital and El-eman Maternity Hospital, Assiut, Egypt. One hundred and sixty patients were included. They were randomly assigned to receive four tablets of 200 μg misoprostol vaginally (max. 800 μg-hospital group) or 12 tablets orally, one every 3 h, over 2 consecutive days (max. 2400 μg-extended low-dose home group). For failed first dose, another similar second dose was given. Primary outcome measure was the percentage of patients with 'medically completed miscarriages' in each group (including complete miscarriages + incomplete miscarriages with successful post-miscarriage misoprostol).

Results: The total number of patients with 'medically completed miscarriages' in home group was 65/79 (82.3%), which was comparable to the hospital group (52/71 or 73.2%) (P = 0.182). However, the majority of patients in home group had significantly successful miscarriages after a single course of low-dose oral misoprostol, experienced much less heavy bleeding attacks and had less systemic side effects.

Conclusion: In low-resource communities, the home-based extended low-dose oral misoprostol protocol proved high efficacy, safety and tolerability in management of first-trimester pregnancy loss.

Keywords: First trimester; Low dose; Oral misoprostol; Pregnancy loss.

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Conflict of interest statement

Conflict of interestAll authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Depicts the study flow chart
See this image and copyright information in PMC

References

    1. National Institute for Health and Care Excellence (NICE). Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage (CG154). London: NICE. 2012. https://www.nice.org.uk/guidance/CG154/chapter/1-Recommendations#managem.... Accessed 11 Nov 2018.
    1. Tang OS, Gemzell-Danielsson K, Ho PC. Misoprostol: pharmacokinetic profiles, effects on the uterus and side-effects. Int J Gynecol Obstet. 2007;99(Suppl 2):S160–S167. doi: 10.1016/j.ijgo.2007.09.004. - DOI - PubMed
    1. Morris JL, Winikoff B, Dabash R, et al. FIGO’s updated recommendations for misoprostol used alone in gynecology and obstetrics. Int J Gynecol Obstet. 2017;138(3):363–366. doi: 10.1002/ijgo.12181. - DOI - PubMed
    1. FIGO Guideline: Misoprostol Recommended Dosages 2012. https://www.figo.org/sites/default/files/uploads/project-publications/Mi.... Accessed 17 Jan 2017.
    1. Tang OS, Schweer H, Seyberth HW, et al. Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod. 2002;17:332–336. doi: 10.1093/humrep/17.2.332. - DOI - PubMed

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