Intravaginal Misoprostol for Treatment of First Trimester Incomplete Mis- carriages: A Randomised Controlled Trial

Objective: To compare the efficacy of medical evacuation using intravaginal Misoprostol 800 mcg eight-hourly in 24 hours with surgical evacuation in treating first trimester incomplete miscarriages. Study design: Randomised controlled trial for one-year duration in a tertiary hospital. One hundred women with first trimester incomplete miscarriage were randomised to undergo either medical evacuation with intravaginal Misoprostol 800 mcg eight-hourly up to three doses or surgical evacuation. Main outcome measures: Successful evacuation between intravaginal Misoprostol and surgical evacuation in treating first trimester incomplete miscarriages. Results: Successful evacuation was achieved in 94% of patients undergoing medical evacuation with intravaginal Misoprostol compared to 98% in the surgical evacuation group (p=0.617). Duration of bleeding between both groups was not significantly different (p=0.491). There was a statistically significant drop in haemoglobin day 1 post treatment in the surgical evacuation group compared to Misoprostol group (0.7 g/dl vs 0.2 g/dl, p= 0.015). There were more patients complained of diarrhea (p=0.001) and fever (p= 0.001) in the Misoprostol group but this was minor and did not require any treatment. Conclusions: Intravaginal Misoprostol 800 mcg eight hourly within 24 hours is an effective and safe alternative treatment to surgical evacuation in treating first trimester incomplete miscarriages.