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Efficacy of misoprostol in relation to uterine position in the treatment of early pregnancy failure
Author(s) -
Reif Philipp,
Tappauf Carmen,
Panzitt Thomas,
Haas Josef,
Lang Uwe,
Klaritsch Philipp
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.11.019
Subject(s) - misoprostol , medicine , incomplete abortion , abortion , obstetrics , mifepristone , medical abortion , missed abortion , pregnancy , retrospective cohort study , gynecology , vaginal bleeding , gestational sac , gestational age , gestation , regimen , surgery , genetics , biology
Objective To evaluate the efficacy of misoprostol in the treatment of missed or incomplete abortion in relation to uterine position. Methods In a retrospective cohort study, misoprostol was evaluated as first‐line treatment for missed and incomplete abortion before 13 gestational weeks. Between 2009 and 2011, women received 600 μg of sublingual misoprostol for missed abortion or 400 μg for incomplete abortion. Follow‐up examinations were performed 7–10 days later, with the option of a second administration of misoprostol. Success was defined by the absence of vaginal bleeding or sonographic signs of incomplete abortion, and falling levels of β‐human chorionic gonadotropin. Results In total, 111 women were included in the study. A single‐dose regimen was effective for 73 (65.8%) women. The overall success rate, including repeat doses, was 73.0% (81/111). There were no significant differences in treatment success between women with missed abortion and those with incomplete abortion (56/89 [62.9%] vs 18/22 [81.8%]; P = 0.152). Anteverted uterine position was associated with significantly higher success rates compared with diverging position (62/86 [72.1%] vs 4/18 [22.2%]; P = 0.001). Conclusion Misoprostol is an effective treatment for early pregnancy failure. Uterine position might impact the success of medical treatment for missed abortion.