Sadia Jalil, Sidrah Nausheen, Asif Zia Akhter.
Sublingual misoprostol in the management of first trimester miscarriage.
Pak J Surg Jan ;26(2):169-73.

Objective: To evaluate the role sublingual misoprostol in the management of first trimester miscarriage. Materials & Methods: Th is is an observational study. Hundred twenty women with diagnosis of missed or incomplete miscarriage less than 13 weeks were recruited. Two doses of 600ug of misoprostol sublingually 3hour apart for missed miscarriage and single dose of 600ug sublingually for incomplete miscarriage was given and left to work for 7-14 days. Women with fever, haemoglobin less than 9 g/dl, heavy vaginal bleeding requiring emergency surgical evacuation , contraindication to prostaglandin therapy were excluded from study. Primary outcome measures were complete evacuation of products of conception, mean induction to delivery time , occurrence of side effects and acceptability. The data was entered and analyzed on SPSS version 13. Results: The efficacy of sublingual misoprostol in our study is 95%. 55% achieved complete evacuation of uterus in first 24hrs whereas 33% achieved it in 48 hours. Th ere were minimal side effects with no major complication seen. Diarrhea was observed by 20% women whereas 15% complained of unpleasant taste. 2-5% had nausea and shivering. Patient satisfaction was 97% and acceptability 95%. Conclusion: Misoprostol promises to have an important public health impact. Women and health care system worldwide could signifi cantly benefi t from this non-invasive treatment option. In low resource countries where infection, hemorrhage and uterine damage are far too commonly reported as consequences of poor surgical care , misoprostol treatment can prove to be a tremendous step towards reducing morbidity and mortality due to abortion complications worldwide.

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