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Abstracts
Author(s) -
Aditi Sinha,
Vivek Goel,
Roxana Chapman,
W Habeeb
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/bjo.12827
Subject(s) - citation , library science , computer science
Approximately 20% of pregnancies end in miscarriage. NICE (2012) stated that vaginal misoprostol can be used for outpatient management of missed or incomplete miscarriage. No guidance is available on suitable ultrasound parameters. Methods Retrospective audit from June 2013 to January 2014 at Medway Maritime Hospital. Cases included all women who underwent outpatient medical management of miscarriage with 800 mcg misoprostol per vagina. Initial ultrasound findings were then compared with final outcomes following treatment. Primary outcome measure was the absence of retained products of conception on ultrasound scan, ie. a complete miscarriage. Results A total of 68 cases were identified. For women with missed miscarriages, gestational sac ranged 4.5–37.7 mm (mean 18.7 mm), and the crown-rump length (CRL) ranged 2–18.1 mm (mean 6.7 mm). For women with incomplete miscarriages, products of conception (POC) ranged 10–30 mm. After administration of misoprostol, all women were rescanned at an average of 10 days later (range 7–21 days). 79% (n = 54) women had complete miscarriages. 15% (n = 10) women required subsequent surgical management of miscarriage, and 6% (n = 4) required a second dose of misoprostol. Of the women requiring further management, 79% had an intact gestational < 12 mm and 57% had a gestational sac < 15 mm. 100% incomplete miscarriages were successfully managed with single dose misoprostol. Conclusion Misoprostol has a very high success rate for outpatient medical management of miscarriage, especially with regards to incomplete miscarriage. Its success rate appears to be reduced with larger, intact gestational sacs that are < 12 mm. This may lead to medical management only being offered to women with smaller gestational sacs and retained POC. However due to the small number of cases, more national data comparing ultrasound scan findings with success rates is required in order to come to a more formal conclusion. FC.02 Imaging in molar pregnancy – a multi-modal approach Chisholme, B; Treharne, A Bonduelle, M