Shabnam Shamim, Tazeen Fatima, Rubina Salahuddin, Ishrat Irfani, Irum Usman.
New trends in medical management of missed miscarriages.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;9(1):481-5.

Objective: To evaluate the efficacy and adverse effects of misoprostol in missed miscarriages. Design: Quasi-experimental study Setting: Department of Obstetrics and Gynecology unit three, Abbasi Shaheed Hospital and K.M.D.C. Duration of study was eight months starting from September 2003. Sample size: 50 patients Method: Fifty patients diagnosed as missed miscarriage ranging between 6 - 24 weeks were included in the study. Each patient after clinical evaluation was administered 400 microgram of misoprostol, which was repeated after six hours if needed. A maximum of 1200 microg was given in 24 hrs. Main outcome measures include successful expulsion of product of conception, dosage required, induction - expulsion interval and side effects. Results: 45 patients (90 %) expelled the products of conception completely without the need for evacuation of uterus. The median induction - expulsion interval was 12.5 hrs. The median dose of drug required was 800 microg. 5 patients (10%) required evacuation, two in emergency due to heavy bleeding and three due to retained products. The efficacy of drug was 90 % The side effects were minimal and well tolerated and patient satisfaction was as high as 96 %. Conclusion: Misoprostol is both safe and effective in medical management of missed miscarriages.

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