scholarly journals Early Pregnancy Failure: Medical versus Surgical Management

2021 ◽  
Vol 16 (2) ◽  
pp. 63-67
Author(s):  
Nasima Begum ◽  
Shahnaz Akhter ◽  
Luna Laila
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Early Pregnancy ◽  
Randomized Study ◽  
First Trimester ◽  
Patient’S Satisfaction ◽  
Medical Evacuation ◽  
Early Pregnancy Failure ◽  
Surgical Evacuation ◽  
Treatment Use

Introduction: Misoprostol is increasingly used to treat women who have a failed pregnancy may be due to blighted ovum (anembryonic gestation), incomplete abortion, missed abortion, inevitable abortion in the first trimester. Medical treatment with Misoprostol is an alternative to conventional surgical treatment. Use of Misoprostol is simple, highly acceptable, noninvasive and preferred by women. In addition to surgical risk and patient's preference, medical evacuation reduces the need for hospital stay and the overall management cost. Objective: To determine the efficacy and safety of Misoprostol for evacuation of uterus in early pregnancy loss and to compare the result with surgical evacuation. Materials and Methods: It was a prospective randomized study conducted on 50 patients at the department of Obstetrics and Gynaecology, Border Guard Hospital, Dhaka during the period from February 2018 to July 2019. Here 25 patients received Misoprostol as medical treatment and 25 patients received surgical treatment. Results: Of the 25 women assigned to receive Misoprostol, 19(76%) had complete expulsion by 24 hours and 22(88%) by 7 days. Complete evacuation after 1st dose was 68% and after 2nd dose 88%. Misoprostol treatment failed in 3(12%) cases and required surgical evacuation. Among the respondents 80% women stated that they would use Misoprostol again if the need arises. Conclusion: Medical treatment with Misoprostol is a cheaper alternative to surgery. Given its success rate near about 88% with mild side effects controllable with additional medication and above all patient’s satisfaction, it should be prioritized over the evacuation curettage in patients who meet the treatment criteria. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 63-67

scholarly journals Prevalence of blighted ovum in first trimester of pregnancy: a hospital based study

2018 ◽  
Vol 8 (1) ◽  
pp. 94
Author(s):  
Abo Bakr A. Mitwally ◽  
Diaa Eldeen M. Abd El Aal ◽  
Nermeen Taher ◽  
Ahmed M. Abbas
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Early Pregnancy ◽  
First Trimester ◽  
Women Health ◽  
Early Pregnancy Failure ◽  
History Of ◽  
First Trimester Of Pregnancy ◽  
Medical Induction ◽  
Blighted Ovum

Background: The aim of this study is to know the prevalence of blighted ovum among pregnant women in 1st trimester attending our hospital during their antenatal visits and to know the fate of blighted ovum either if there is spontaneous expulsion of the sac or need of medical induction or surgical evacuation.Methods: This observational study was conducted at Obstetrics and Genecology Department, Women Health Hospital and Sahel Selim Hospital, Egypt from November 2015 to February 2018. All patients recruited in this study attended the antenatal care clinics for antenatal follow-up during their first-trimester of pregnancies.Results: All cases of the study were less than 14 weeks. The mean gestational age was 8.93±1.01 (7.0-11.0) weeks. In patients less than 20 years old, (73%) there is a significant increase in surgical treatment (dilatation & curettage) after failure of medical treatment, patients more than 40 years old (50.7%) there is a significant increase in medical treatment after success taking misoprostol so there is no need to a surgical treatment by (dilatation & curettage) in the majority of cases.Conclusions: The prevalence of blighted ovum was 15.6%. Also, the prevalence of blighted ovum was statistically significant increased with increase maternal age and also, we noticed that there was a statistically significant association between early pregnancy failure and a history of previous early pregnancy loss.

scholarly journals Ultrasound Evaluation of Pregnancy in the First Trimester

2010 ◽  
Vol 4 (1) ◽  
pp. 17-28 ◽  
Author(s):  
George M Graham
Keyword(s):  
Early Pregnancy ◽  
First Trimester ◽  
Transvaginal Sonography ◽  
List Type ◽  
Intrauterine Pregnancy ◽  
Ultrasound Evaluation ◽  
Early Pregnancy Failure ◽  
Ultrasound Findings ◽  
Ultrasound Technology ◽  
First Trimester Ultrasound

Abstract Improvements in ultrasound technology, including transvaginal sonography and higher frequency probes, have led to a better understanding of early pregnancy development. These advances and the increasing availability of ultrasound allow women to have an earlier and more accurate assessment of their pregnancy. First trimester sonographic signs have been identified that can be used to reassure women that their pregnancy is progressing normally or counsel them that their pregnancy will fail. In addition, first trimester ultrasound can accurately predict the type of twinning in multiple gestations, allowing for appropriate counseling and management. Objectives Know the first trimester ultrasound findings of a normal intrauterine pregnancy Understand the ultrasound findings that diagnose an early pregnancy failure Know the ultrasound criteria used to diagnose a multifetal gestation

Quality of Life in Women Undergoing Medical Treatment for Early Pregnancy Failure

2005 ◽  
Vol 34 (4) ◽  
pp. 473-481 ◽  
Author(s):  
Tonja R. Nansel ◽  
Faith Doyle ◽  
Margaret M. Frederick ◽  
Jun Zhang
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Early Pregnancy ◽  
Pregnancy Failure ◽  
Early Pregnancy Failure

scholarly journals Use of Oral Misoprostol for the Treatment of Incomplete Abortion

2014 ◽  
Vol 8 (2) ◽  
pp. 30-33
Author(s):  
S Kayastha ◽  
H Tuladhar ◽  
S Gurung ◽  
S Jaishe
Keyword(s):  
Side Effects ◽  
College Teaching ◽  
First Trimester ◽  
Medical College ◽  
Medical Evacuation ◽  
Obstetrics And Gynaecology ◽  
Incomplete Abortion ◽  
Surgical Evacuation ◽  
To Come

Aims: This study was done to assess the feasibility and acceptability of use of Misoprostol 600 mcg orally for treatment of incomplete abortion. Methods: A hospital based prospective study was carried out in the Department of Obstetrics and Gynaecology of Nepal Medical College Teaching Hospital from 1st November 2010 to 30th May 2013. All cases of first trimester incomplete abortion diagnosed clinically or by ultrasonogram were included in the study. They were given 600 mcg of Misoprostol orally. They were sent home, with advice to come for follow up after one week. Routine Ultrasound was carried out on follow up visit to confirm complete abortion. The side effects, complications and patient satisfaction was assessed and recorded. Results: Out of 86 patients, 8.1% (7) had to undergo surgical evacuation. So the success rate was 91.9% (79 cases). All the cases which needed evacuation were of higher gestation, that is, nine weeks or more. The commonest side effect was severe abdominal pain (81.4%). Three cases required emergency surgical evacuation within 24 hours due heavy bleeding.Conclusions: It is feasible and acceptable to use Misoprostol orally for medical evacuation, especially in earlier gestation of first trimester incomplete abortion. Side effects were common but were acceptable and tolerable by the patients. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 30-33 DOI: http://dx.doi.org/10.3126/njog.v8i2.9766  

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