Misoprostol for medical management of first-trimester pregnancy failure

Surgical evacuation is currently the standard approach for the termination of pregnancies of a duration less than 12 weeks, but it is associated with some morbidity. Complications of surgical evacuation can be avoided by medical abortion. Misoprostol, a prostaglandin, can be administered orally, sublingually, intravaginally, or rectally for medical abortions. Our study group consisted of 54 pregnant women with the ultrasound diagnosis of a first-trimester pregnancy failure. Non-viable pregnancies, i.e. with an embryo greater than 7 mm with no cardiac activity, an irregular gestational sac with a mean diameter greater than 16 mm, or a gestational sac greater than 15 mm without a fetal pole were considered pregnancy failures. Women with a closed cervical os and minimal vaginal bleeding were enrolled. Women with systemic diseases, hemoglobin concentrations less than 10 gydl, and known sensitivity to misoprostol were not enrolled. The women were hospitalized and informed consent was obtained. After routine examinations and tests, they were administered 200 mg (1 tablet) of misoprostol (Cytotec; G. D. Searle, Istanbul, Tur-