Medical Versus Surgical Abortion In The First Trimester Regarding The Amount Of Blood Loss(Randomized Controlled Trial)

Abstract

The study used to compare between surgical procedure versus vaginal misoprostol treatment of missed abortion to evaluate the estimated blood loss and rate of complications. This is a prospective randomized controlled study. It was carried out at Ain Shams university maternity hospital during the period from January 2015 till September 2015. A total of 88 women with clinical diagnosis of first trimester missed abortion were recruited from outpatient clinic . The first group of patients (44) were treated with Misoprostol 800ug (MISOTAC SIGMA®) vaginally maximally for three days; the second group (44) patients were treated with surgical evacuation. We found that the use of vaginal misoprostol in dose of 800ug/day for 3 days gave evacuation rate of( 66%), 29 cases were completely evacuated from 44 patients. 15 cases (34%) needed surgical evacuation. The procedure screened by ultrasound to be sure that complete evacuation was done. Summary - 71 - In our study as regards the side effects developed during Misoprostol intake compared with surgical evacuation. In medical group, 18 patients(40%) suffered from nausea, 17 patients (36.4%) suffered from vomiting, 10 patients (22.7%) suffered from diarrhea, 3 patients (6.8 %) suffered from fever not more than 38.5 c and 8 patients (18.18%) had severe abdominal cramps. In Surgical group, 3 patients (6.8%) suffered from nausea, 3 patients (6.8%) had vomiting, 2 patients (4.5%) had fever below 38.5c, 2 patients (4.5%) had diarrhea and 2 patients (4.5%) had severe abdominal cramps. When we compared the complete expulsion rate (success rate) in the two groups we found 66% of medical group with more complication to 97.7% of surgical evacuation.