The efficacy of misoprostol in the first trimester miscarriage treatment - an individual patients' data analysis
- 1 January 2019
- journal article
- research article
- Vol. 40 (3), 152-158
Abstract
INTRODUCTION: The study aimed to detect factors predicting a successful pharmacological induction of first-trimester miscarriage. MATERIAL AND METHODS: A prospective, cohort research was conducted at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between years 2011-2015. 642 women diagnosed with first trimester miscarriage qualified for pharmacological induction with misoprostol were included in the study. Each patient underwent repeatable doses of 800mcg misoprostol vaginally. The endpoint was complete excretion of all tissues, with no need to perform surgical curettage. Type of miscarriage, gravidity, parity, number of doses, time of drug administration and side effects were analysed as possible factors influencing the results. The statistical analysis was performed with STATISTICA 10.0 software. RESULTS: The percentage of successful miscarriage induction was 83.6%. Two main factors corresponded with successful pharmacological treatment in regression analysis: number of administered doses (adjusted OR 1.64; 95% CI 1.18-2.29) and week of gestation (aOR 1.22; 95%CI 1.03-1.44). The success of the pharmacological induction of miscarriage was significantly decreased if the woman had a history of caesarean section (aOR 0.34; 95% CI 0.2-0.57). 2.2% of patients experienced benign side effects of the therapy. CONCLUSIONS: Pharmacological induction is an effective and safe treatment method of first trimester abortion in the majority of cases. The knowledge of factors influencing the efficacy of misoprostol may help clinicians in proper counselling and individualisation of therapy.Keywords
This publication has 16 references indexed in Scilit:
- Predictors of uterine evacuation following early medical abortion with mifepristone and misoprostolContraception, 2015
- Increasing the management options for early pregnancy loss: the economics of miscarriageAmerican Journal of Obstetrics and Gynecology, 2015
- Beyond usual care: the economic consequences of expanding treatment options in early pregnancy lossAmerican Journal of Obstetrics and Gynecology, 2015
- An approach to evaluate the efficacy of vaginal misoprostol administered for a rapid management of first trimester spontaneous onset incomplete abortion, in comparison to surgical curettageArchiv für Gynäkologie, 2013
- WHO recommendations for misoprostol use for obstetric and gynecologic indicationsInternational Journal of Gynecology & Obstetrics, 2013
- The management of missed miscarriage in an outpatient setting: 800 versus 600 μg of vaginal misoprostolAustralian and New Zealand Journal of Obstetrics and Gynaecology, 2011
- Clinical indicators for success of misoprostol treatment after early pregnancy failureInternational Journal of Gynecology & Obstetrics, 2007
- Bleeding patterns after misoprostol vs surgical treatment of early pregnancy failure: results from a randomized trialAmerican Journal of Obstetrics and Gynecology, 2007
- Risk factors for unsuccessful medical abortion with mifepristone and misoprostolActa Obstetricia et Gynecologica Scandinavica, 2007
- Expectant, Medical, or Surgical Management of First-Trimester Miscarriage: A Meta-AnalysisObstetrics & Gynecology, 2005