A Comparison of Vaginal Misoprostol 800 µµµµµg Versus 400 µµµµµg in Early Pregnancy Failure: A Randomized Controlled Trial
Chalisa Prasartsakulchai MD*, Yuen Tannirandorn MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University
Aim : To compare the efficacy, side effects and patient satisfaction between 800 µg versus 400 µg intravaginal
misoprostol for early pregnancy failure.
Materials and Methods : Women diagnosed as early pregnancy failure were randomly assigned to receive
either 800 µg or 400 µg intravaginal misoprostol. The second dose was administered if there was no evidence
of abortion in 24 h. The treatment failure was reffered to no complete abortion within 48 h. Dilatation and
curettage was performed if the patients had heavy vaginal bleeding or evidence of incomplete abortion or no
complete abortion.
Results : 25 patients were randomized to receive 800 µg and 25 patients were to receive 400 µg misoprostol.
Complete abortion was not significantly different between the 2 groups (72%, 76% respectively). Although
median time to abortion in the 800 µg group was significantly shorter, the patients experienced more side
effects especially fever which was significantly different (P = 0.04). In the 800 µg group, 2 patients had heavy
vaginal bleeding and one patient developed endometritis. There was no significant difference in the patients’
satisfaction between both groups.
Conclusions : 400 µg of vaginal misoprostol are as effective as 800 µg in producing complete abortion in
early pregnancy failure with less side effects and similar patient satisfaction.
Keywords : Early pregnancy failure, First trimester, Misoprostol, Pregnancy termination.
