Introduction Miscarriage is one of the commonest complications in pregnancy and a source of some anxiety to women and their families. Medical management of miscarriage (MMM) with misoprostol is often chosen by women as a method of managing this complication. This study aimed to study the outcomes of women undergoing MMM in order to guide local management.
Methods Prosepective study analysing outcomes of women undergoing MMM from September to December 2013 in a large tertiary level unit.
Results Fifty five suitable women chose to undergo MMM. One woman did not attend for follow up, and one required an emergency evacuation of retained products of conception (ERPC) for heavy bleeding after taking misoprostol.
Twenty eight women were considered “complete” and therefore successful treatment of miscarriage (51%). Twenty five had some evidence of retained products of conception, of which nineteen required another intervention such as repeated medications or surgical management (34.5%). Seven women underwent a second course of misoprostol and were still incomplete and then underwent an ERPC.
Conclusion Internationally it is quoted that the success rate of medical management of miscarriage is nearly 90% with a 5% chance of requiring an ERPC or repeat dose of medications. Risk factors for requiring a repeat intervention include retroverted uterus. Further study is required in order to determine why MMM is not as successful in this unit, including patient demographics, our diagnois of incompelte miscarriage and medication regimes.
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