[Misoprostol in substitution at uterine curettage in early pregnancy failure].
Nyckelord
Abstrakt
OBJECTIVE
To evaluate the effectiveness of misoprostol administered vaginally for uterine evacuation in interrupted early pregnancies and the time between the administration and emptying correlated with gestational age.
METHODS
Clinical trial with 41 patients with pregnancies interrupted between the 7th and the 12th gestational weeks. The mean age was 27.3 (± 6.1) years. Mean parity was 2.2 (± 1.2) deliveries. The average number of previous abortions was 0.2 (± 0.5). Misoprostol was administered vaginally in a single 800 µg dose and transvaginal ultrasound was performed after 24 hours. Abortion was considered complete when the anteroposterior diameter of the endometrial cavity measured < 15 mm. Patients whose diameter remained was larger than 15 mm underwent uterine curettage. Two groups (< 8 and > 8 weeks of gestational age) were compared using the binomial test and Student's t test regarding outcome: frequency of complete abortion and the interval between administration of misoprostol and abortion (in minutes). The level of significance was 5%.
RESULTS
The mean gestational age at diagnosis was 8.5 weeks (SD = 1.5). The intervals between administration of misoprostol and uterine contractions and between the administration and abortion were 322.5 ± 97.0 minutes and 772.5 ± 201.0 minutes, respectively. There was complete abortion in 80.3%. The success rate was 96.2% for the first group and 53.3% for the second (p < 0.01). We observed a statistically significant difference in time between administration and uterine evacuation (676.2 ± 178.9 vs. 939.5 ± 105.7 minutes, p < 0.01). The side effects observed were hyperthermia (12.1%), nausea (7.3%), diarrhea or breast pain (2.4%). No case of genital infection was observed.
CONCLUSIONS
The use of vaginal misoprostol is a safe and effective alternative to curettage for interrupted early pregnancies, being better in pregnancies up to the 8th week. The time interval until emptying was lower in pregnancies that were interrupted earlier.
