COMPARATIVE STUDY OF SUBLINGUAL VERSUS VAGINAL MISOPROSTOL FOR THE MANAGEMENT OF MISSED MISCARRIAGEAT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

Dr. Swati Kochar; Dr. Kamlesh Kumar Meena; Dr. Santosh Khajotia; Dr. Sushma

Volume : IX, Issue : IV, April - 2019

COMPARATIVE STUDY OF SUBLINGUAL VERSUS VAGINAL MISOPROSTOL FOR THE MANAGEMENT OF MISSED MISCARRIAGEAT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

Dr. Swati Kochar, Dr. Kamlesh Kumar Meena, Dr. Santosh Khajotia, Dr. Sushma

Abstract :

Objective: To compare the efficacy of sublingual and vaginal misoprostol in the medical management of missed miscarriage up to 20 weeks of gestation. Methodology: A hospital based randomized comparative study comprised of 200 females up to 20 weeks pregnancy with missed abortion was conducted in the Department of Obstetrics and Gynecology, Sardar Patel Medical College associate groups of hospitals, Bikaner, Rajasthan. Women in group A received 400 μg of misoprostol sublingually every three hours for a maximum of 5 dose and those in group B received 400 μg of misoprostol vaginally every three hours for a maximum of 5 doses. Women who aborted were sent for ultrasound pelvis to exclude any RPOCs. Results: Mean decrease in hemoglobin in sublingual group before and after abortion there was significant difference with p–value 0.021 and similarly, in per–vaginal group there was significant difference with p–value 0.037. Mean decrease in Hb in both groups was also comparable implying similar blood loss in these two methods. Majority of abortions (45%) were performed in 5–8 weeks of gestation. Majority of abortion occurred at number of dose 3 (44% in sublingual; 39% in per–vaginal) followed by number of dose 2 (25% in sublingual; 27% in per–vaginal). The mean duration for abortion in sublingual group was 6.1±3.6 hours and in per–vaginal group is 6.6±3.9hours. Complete abortion was seen in 83 % women in sublingual and 85 % in per–vaginal and this difference was not found statistically significant (P=0.793). Conclusion: Misoprostol as a single agent can be used safely and effectively as 1st line treatment for abortion both by sublingual and vaginal route.