Ammara Kashif, Jaweria Faisal, Zobia Jawad, Fatima Chaudhry Inayat, Nargis Shabana, Sadia Kanwal.
Comparison of Vaginal Misoprostol with Suction Evacuation for the Management of First Trimester Spontaneous Miscarriage.
Pak J Med Health Sci Jan ;14(2):517-21.

Aim: To compare the management outcome of vaginal Misoprostol with suction evacuation for treatment of 1st trimester spontaneous miscarriages. Study Design: Quasi Experimental Study. Place and duration of study: Mother and Child health center, PIMS Islamabad, from Aug 2011 to Aug 2012. Methodology: Total 60 women with early pregnancy failure were recruited in this study. These women were divided randomly into two groups i.e., Group A and Group B. Group A received medical management i.e. vaginal Misoprostol 800 ug (4 Tablets of Cytotec 200 micrograms each) repeated after an interval of 24 hours once if needed and Group B underwent surgical intervention by suction evacuation. Main outcome measures were, mean management time, complete evacuation of products of conception, appearance of side effects and comparison of the costs. Results: In Group A total of 73.3% and in group B100% patients had complete evacuation. The management time was 35 hours in group A and 16 hours in Group B. Misoprostol insertion resulted in heavy vaginal bleeding and abdominal pain in 20 (66.7%), fever in 3 (10%)and vomiting in 2 (6.7%), patients. Only one patient (3.3%) had vomiting, pain and bleeding in Group B. The cost of medicine in Group A was Rs 280 and in Group B it was Rs 1500. Conclusion: Surgical evacuation is costly but better than medical treatment in terms of complete evacuation in less time with minimal side effects.

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