Open AccessMISSED ABORTION
Author(s) -
Ikramullah Khan,
Ik Tiar,
Noreen Shezadi
Publication year - 2010
Publication title -
the professional medical journal/the professional medical journal
Language(s) - English
Resource type - Journals
eISSN - 2071-7733
pISSN - 1024-8919
DOI - 10.29309/tpmj/2010.17.02.2433
Subject(s) - medicine , misoprostol , cervical canal , vomiting , vaginal bleeding , abdominal pain , abdomen , anesthesia , surgery , obstetrics , randomized controlled trial , pregnancy , abortion , cervix , genetics , biology , cancer
Objective: To compare the effectiveness of extra-amniotic cervical catheter and vaginal misoprostol as a cervical priming agent prior to surgical evacuation in first trimester missed abortions. Design: Randomized clinical trial. Setting: At lady Willingdon hospital gynecology unit 1 from 1st March 2008 to 28th February 2009. Methods: 100 patients with diagnosis of missed abortions of up to 12 weeks + 6 days were studied. The primigravida were included. They were divided in two groups. In group. A (50) patients 400 microgram (2 tablet ) misoprostol were placed high up in posterior vaginal fornix while in group B (50) patients extra-amniotic. Foleys catheter was placed aseptically 6 hour before surgical intervention as priming agent. Exclusion criteria: All multigravida, patients sensitive to prostaglandin, and with disturbed coagulation were excluded. Main Outcome Measures: The main out comes are 1, cervical dilatation and effacement 2,complications like fever, pain lower abdomen, headache and vomiting 3, amount of bleeding in ml after application of agent. Results: Cervical catheter proved to be good cervical priming agent comparable to misoprostol. Cervical dilatation was significantly better in misoprostol (> 10 mm 44%, > 8mm 30%, > 5mm 20%) as compared to Foleys group (>10 mm 24%, > 8mm 38%, > 5mm 20%) while in 3 (6%) dose of misoprostol was repeated and in 10 (20%) patient in Foleys group has no effect. The side effects occurred in both groups but systemic effects were more in misoprostol, pain lower abdomen 42% VS 46%, backache 18% VS 26%, fever 10% VS nil, headache 16% VS nil and no side effect 14% VS28%) as compared to Foleys catheter. Systemic effects were absent in Foleys catheter due to inert nature. Bleeding occurred in all patientswith misoprostol while it was absent in 48% cases in Foleys group (>60ml 42% VS 8%, <40ml 32% VS 14% < 20ml 26% VS 30%). 48% cases had no bleeding in Foleys group. Conclusion: Cervical catheter proved to be good priming agent due to lesser systemic side effects as compared to misoprostol.