MANAGEMENT OF EARLY PREGNANCY FAILURE WITH MISOPROSTOL: RELATION TO SIZE OF GESTATIONAL SAC
Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University
The aim of this study was to assess the relation between size of gestational sac and the success of misoprostol in complete evacuation of missed miscarriage. The study included 35 women with missed miscarriage and anembryonic pregnancy between 10 and 15 weeks. Women with sacs 20 mm or above in diameter as measured on TVS were chosen. Treatment started with a single dose of 400 μg misoprostol vaginally. Patients who failed to pass products of conception overnight received a course of 200 μg oral misoprostol every 8 hours for 7 days. Successful treatment is judged by complete passage of the gestational sac confirmed by its disappearance on follow up TVS. Complete miscarriage occurred in 77.1% of the studied group. There was a significant association between treatment failure and large sac diameter. Odds ratio of failure if sacs were larger than 28 mm in diameter was 8.6 (95% CI: 1.4-52.7). We can conclude that success rate of misoprostol was negatively correlated with the size of the gestational sac as measured through transvaginal ultrasonography. Further studies with larger samples are needed to confirm the predictability of gestational sac diameter in treatment success of medical induction of abortion.