Efficacy and safety of misoprostol compared to methotrexate plus misoprostol for the medical management of abortion in Bogotá, Colombia. A randomized clinical trial
DOI:
https://doi.org/10.18597/rcog.251Keywords:
retained abortion, anembryonic pregnancy, medical management, misoprostol, methotrexateAbstract
Objective: evaluating the efficacy and safety of misoprostol compared to methotrexate plus misoprostol for the medical management of patients suffering from retained abortion/anembryonic pregnancy.
Materials and methods: this was a randomized clinical experiment. Patients having a gestational age of less than 63 days who were suffering anembryonic pregnancy/retained abortion as diagnosed by ecography were included. They were randomized into 2 groups receiving 50 mg intramuscular methotrexate plus 800 mcg intravaginal misoprostol (group 1) or 800 mcg intravaginal misoprostol (group 2). The complete abortion rate was evaluated, including patients who required a rescue dose with their respective complications.
Results: a total of 52 patients were randomized to the combined therapy group and 66 to the monotherapy group; 92% presented complete abortion by ecography in the misoprostol plus methotrexate group and 86% in the misoprostol group (p=0.24). Two of the patients from the combined therapy group (6%) required a rescue dose compared to five in the misoprostol group (11%) (p=0.348). Three patients required obstetric uterine dilation and curettage (D&C) (in the combined therapy group whilst five needed it in the monotherapy with misoprostol group (p=0.69). Both schemes proved safe for the patients.
Conclusions: the profile for medical management of females having a gestational age of less than 63 days who were diagnosed as having retained abortion or anembryonic pregnancy receiving intravaginal 800 mcg de misoprostol monodosis did not show significant differences when compared to a combined methotrexate and misoprostol therapy scheme.
Author Biographies
Mortimer Arreaza-Graterol
Jorge A. Rodríguez-O
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