Korean J Obstet Gynecol.  2012 Apr;55(4):230-236. 10.5468/KJOG.2012.55.4.230.

Comparison of intracervical laminaria plus vaginal misoprostol and vaginal misoprostol only with variable dosages for medical abortion within 12 hours

Affiliations
  • 1Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea. ooooobbbbb@catholic.ac.kr

Abstract


OBJECTIVE
To compare the effectiveness of intracervical laminaria plus vaginal misoprostol and vaginal misoprostol only with variable dosages by analyzing the rate of spontaneous gestational sac expulsion for medical abortion within 12 hours.
METHODS
This study was performed in 94 patients for missed abortion at Department of Obstetrics and Gynecology, St. Paul's Hospital, the Catholic University of Korea for 5 years (2004-2008). Forty seven patients were managed with laminaria insertion and intravaginal misoprostol 200 microg, 400 microg, or 800 microg at admission or outpatient clinic. The others were treated with only misoprostol at the same dose. We analyzed the rate of spontaneous expulsion of gestational sac within 12 hours.
RESULTS
In non-laminaria group, spontaneous expulsion rate increased according to the doses of misoprostol (4.2%, 37.5%, and 33.3%, in 200 microg, 400 microg, and 800 microg, respectively, P =0.028). Between groups with the same misoprostol doses, no difference was observed in the spontaneous expulsion of the fetal sac within 12 hours according to the use of laminaria. On multivariate logistic regression analysis, factors that were associated significantly and independently with spontaneous expulsion of conceptus were misoprostol > or =400 microg and gestational age.
CONCLUSION
Treatment of missed abortion with 400 or 800 microg misoprostol vaginally is safe and acceptable method, and reduced the number of surgical interventions.

Keyword

Misoprostol; Laminaria; Missed abortion; Pregnancy
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