Intrauterine Extra-amniotic Misoprostol Solution is Effective for Termination of Second Trimester Missed Abortion: A clinical pilot descriptive study

Abstract

Objectives: The purpose of this study was to determine the efficacy and safety of intrauterine extra-amniotic misoprostol solution for termination of the second trimester missed abortion. Methods: A clinical pilot descriptive study that was done in Women Health Hospital, Assiut University, Egypt between March 2015 and June 2015. Fifty patients having missed abortion of gestational age between 13 to 24 weeks were included in the study. Insertion of an intrauterine Foley’s catheter followed by infusion of sterile misoprostol solution through a sterile infusion set at a constant drip rate. The primary outcome was successful expulsion of the fetus in 12 hours after starting misoprostol infusion. Results: The mean age of the study group was 27.25±4.08, the mean BMI was 26.35±3.6, the mean gestational age was 22.85±3.4 and the mean parity was 2.5±1.5. The mean induction expulsion interval was 5.27±2.66 hours. Six cases (12%) needed analgesic. Surgical evacuation of retained contents was needed in 3 cases (6%). Side effects in the form of rigors, fever and diarrhea were recorded in 4 cases (8%). No serious maternal events were recorded. Conclusion: Our results showed that intrauterine extra-amniotic misoprostol solution instillation appear to be effective and safe for termination of a second trimester missed abortions.