Authors: Nahed E Allam,Taiseer  M Mohamed,Samar  M Wahba


Abstract

Misoprostol alone regimen is effective to achieve complete abortion in early failure pregnancy; many protocols prescribed wide range of success rate. Tailoring dose of misoprostol could be beneficial for both clinician and patients. The objective of this work is to design a scoring system to modify misoprostol dose used for treatment of early pregnancy loss. One hundred pregnant women at ≤13weeks’gestation at a clinical diagnosis of early pregnancy failure attended the outpatient clinic for termination of pregnancy. Study variables included; ultrasound factors such as mean sac diameter, foetal pole, cervical length as well as the clinical factors such as parity, history of previous cesarean section, abdominal pain and mild vaginal bleeding before initiating the treatment. Fifty two percent successfully aborted after first dose, 28% after second dose, with overall 82 %success rate after 48hours and 18 % failed to respond to misoprostol and suction evacuation was needed. Mean sac diameter and parity both factors showed inverse proportionate to success rate. Ultrasound criteria (mean sac diameter, fetal pole length and cervical canal length) all showed statistically significant difference between failed and succeeded cases. Fine-tuning the misoprostol dose based on scored clinical and ultrasound variables would be beneficial in choosing the least effective dose.

Keywords

Early pregnancy failure (missed abortion, anembryonic sac)

 

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Designing a Scoring System for Predicting Effectiveness of Misoprostol–Alone Regimen Used in Early Pregnancy Failure