Clinical Medicine Reviews in Women's Health

Aim: The aim of this study was to evaluate the role of oral misoprostol following surgical evacuation of first trimester abortion in reducing the amount and duration of vaginal bleeding and also to evaluate patient tolerability to this drug.

Patients and methods: This randomized placebo-controlled study was conducted on 120 patients with gestational ages of 6–12 weeks at the Obstetrics and Gynecology Department, Tanta University, Egypt, from July 2015 to May 2016. All patients underwent surgical evacuation for abortion regardless of its type (missed, inevitable, or incomplete abortion). Patients who were hypersensitive to misoprostol, had septic abortion, had ectopic pregnancy, or had molar pregnancy were excluded. Patients were allocated randomly into two groups equally: group I who will receive oral misoprostol 200 µg following surgical evacuation for two days and group II who will receive placebo and serve as a control group.

Results: There was no significant difference between the two groups with respect to hemoglobin (P = 0.426) and hematocrit (P = 0.547) before surgical evacuation. There was a significant difference between the two groups with respect to hemoglobin (P = 0.001) and hematocrit (P = 0.002) after 15 days following evacuation. There was a statistically significant difference between the two groups with respect to days of vaginal bleeding or spotting (P = 0.001). There was also a statistically significant difference between the two groups with respect to days of mild bleeding (P = 0.001), moderate bleeding (P = 0.005), and severe bleeding (P = 0.023). In the misoprostol group (GI), there was no case of retained product (0.0%), whereas in the placebo control group (GII), there were five cases (8.33%) of retained product who needed repeated curettage. A statistically significant difference was observed between the two groups with respect to presence of retained product (P = 0.020).

Conclusion: Reduction of both the amount and duration of vaginal bleeding after the surgical evacuation of first trimester abortion was observed in the oral misoprostol group and was associated with high success rate and low incidence of side effects.