Effectiveness, safety and acceptability of outpatient medical treatment of first trimester miscarriage.

Abstract

Objective: To evaluate the effectiveness, safety and acceptability of outpatient medical treatment of first trimester miscarriage with misoprostol. Study Design: Descriptive Longitudinal study. Setting: Outpatient Department, Gynae Unit 1 of Abbasi Shaheed Hospital. Period: September 2020 to April 2021. Material & Methods: Patients of first trimester miscarriage up to 10 weeks gestation were included in the study through non probability consecutive sampling technique. Written consent were taken from all the patients fulfilling inclusion criteria and advised patients to start tab. Misoprostol 400microgram 4 hrly 3 doses in 24hours orally at home. Patients were advised to follow in outpatient department after 72 hours with report of ultrasound if no active complain. Those who came with heavy bleeding per vaginum or with severe pain, we abandoned the medical treatment and surgical evacuation was done. After completion of treatment either by medical or surgical we took opinion from patients regarding their satisfaction with the chosen method. Results: In this study 60 patients of first trimester miscarriage, medically managed with misoprostol were included. Overall assessment was done for effectiveness, safety and acceptability of medical management by Misoprostol. 23.3% patients needed further surgical evacuation and 76.7% patients were managed successfully by medical treatment, overall satisfaction was reported in 73.3% patients, and treatment acceptance showed by 76.7%. According to 78.3% they will prefer the treatment again. Conclusion: Misoprostol is safe and effective drug for the termination of first trimester miscarriage up to 10 weeks, orally, as outpatient treatment, with high success rates, patient acceptability and tolerable side effects.