Efficacy and Reliability of Telephone Follow up Management of First Trimester Incomplete Miscarriage after Medical Treatment with Misoprostol

Abstract

iscarriage is defined as the loss of clinically recognized pregnancy, prior to 20 weeks gestation. It is the most common complication of pregnancy affecting around 10 to 15 % of clinically recognized pregnancies. The incidence is much higher if losses before the next menstrual cycle are considered; approaching 50 to 75% of all fertilized ova. Three options exist for managing a miscarriage: Surgical evacuation, medical management and expectant management. Medical method for treatment of miscarriage is now considered an effective alternative to surgical evacuation. Misoprostol can be administered sublingually, orally, vaginally and rectally. The time to peak serum concentration was found to be short in the sublingual route. This is due to rapid absorption through the sublingual mucosa, the abundant blood supply under the tongue, the relatively neutral PH in the buccal cavity and avoidance of the first-pass metabolism via the liver.