The use of misoprostol for early pregnancy failure

  title={The use of misoprostol for early pregnancy failure},
  author={Oi Shan Tang and Pak-chung Ho},
  journal={Current Opinion in Obstetrics and Gynecology},
  • O. Tang, P. Ho
  • Published 1 December 2006
  • Medicine
  • Current Opinion in Obstetrics and Gynecology
Purpose of review This paper reviews the current management of early pregnancy failure with particular emphasis on the use of misoprostol. Recent findings Medical management using misoprostol is effective for the management of miscarriages. The success rate ranged from 84 to 93% depending on the regimen of misoprostol, the duration of waiting period and the types of miscarriage. Summary Miscarriages occur in 10 to 20% of all pregnancies. Surgical evacuation has been used to empty the uterus… 

Use of Misoprostol in the Management of Early Pregnancy Loss

Vaginal Misoprostol is proved to be effective and safe in cases of incomplete abortion, missed abortion and blighted ovum and in the cases that failed to achieve complete evacuation by medical means using misoprostols, the option of surgical manual vacuum aspiration was offered.

Medical compared with surgical management in induced abortions and miscarriages

In Finland, medical abortion offered a good alternative to surgical method without increasing the risk of repeat abortions, but with an increased risk of short-term adverse events, and neither of the methods was economically superior in treating miscarriage.

Combination therapy with mifepristone and misoprostol for the management of first trimester miscarriage: Improved success

  • A. DunfordR. Fyfe
  • Medicine
    The Australian & New Zealand journal of obstetrics & gynaecology
  • 2018
Mifepristone is an anti‐progesterone shown to improve outcomes when used in conjunction with misoprostol for first trimester abortion, however, there have been conflicting results when it has been added to treatment regimens for miscarriage.

Comparison of vaginal misoprostol application versus curettage in treatment of early pregnancy failure: A randomization clinical trial study

Application of vaginal misoprostol can be used as treatment in early pregnancy failure but curettage is superior in women with first time pregnancy.

Outcome of Single-dose Vaginal Misoprostol in Early Missed Miscarriage

The data support the use of 800-μg misoprostol (via the vaginal route) as effective management for first trimester–missed miscarriage and further evaluation of this approach is needed to assess patient acceptability, and use of repeated doses to achieve more effective results.

Medical treatments for incomplete miscarriage.

The available evidence suggests that medical treatment, with misoprostol, and expectant care are both acceptable alternatives to routine surgical evacuation given the availability of health service resources to support all three approaches.

Medical treatments for incomplete miscarriage.

The effectiveness, safety, and acceptability of any medical treatment for incomplete miscarriage (before 24 weeks), or alternative methods of medical treatment, with randomised controlled trials comparing medical treatment with expectant care or surgery, is assessed.

The management of miscarriage.



A Comparison of Medical Management With Misoprostol and Surgical Management for Early Pregnancy Failure

Treatment of early pregnancy failure with 800 microg of misoprostol vaginally is a safe and acceptable approach, with a success rate of approximately 84 percent.

High-dose misoprostol used in outpatient management of first trimester spontaneous abortion

This protocol of 400 μg intravaginally misoprostol every 4 h as three daily doses for a maximum of 3 days, may offer an efficacious and safe alternative to the outpatient management of first-trimester missed abortion.

Medical management of early fetal demise using a combination of mifepristone and misoprostol.

The combination of oral mifepristone 200 mg with vaginal or oral misoprostol is an alternative to surgical management of early fetal demise, although it is not as effective as surgery.

A randomized controlled trial comparing medical and expectant management of first trimester miscarriage.

Medical management using 600 microg misoprostol vaginally is more effective than expectant management of early pregnancy failure and patient acceptability was superior to expectants management.

Early Pregnancy Failure—Current Management Concepts

There is a significant lack of information from large-scale studies about when treatment is necessary and the relative efficacy, rates of side effects, and acceptability of these various treatment options for early pregnancy failure.

Medical treatment of missed abortion using misoprostol

A randomized trial to compare the use of sublingual misoprostol with or without an additional 1 week course for the management of first trimester silent miscarriage.

Sublingual misoprostol is useful for the management of silent miscarriage and an additional 1 week course did not improve the success rate or shorten the duration of vaginal bleeding Instead, it increased the incidence of diarrhoea.

Expectant, Medical, or Surgical Management of First-Trimester Miscarriage: A Meta-Analysis

The relative benefits and harms of different management options for first-trimester miscarriage were quantified, finding that one additional success can be achieved among 3 women treated surgically rather than medically.

Endometrial thickness after misoprostol use for early pregnancy failure

A prospective randomized study to compare the use of repeated doses of vaginal with sublingual misoprostol in the management of first trimester silent miscarriages.

Sublingual misoprostol may offer an alternative for women who do not like repeated vaginal administration of the drug, and is useful for the management of silent miscarriage in terms of complete miscarriage rate and patient acceptability.