Efficacy of Vaginal Misoprostol for Missed Abortion Management: A Retrospective Case Series

Background: Misoprostol is widely used for the medical management of missed abortion, but response rates vary across settings. We evaluated the efficacy of ۸۰۰ mcg vaginal misoprostol for first-trimester missed abortion at Rabia Balkhi Hospital, Kabul, Afghanistan.Methods: This retrospective case series included ۴۹۲ women diagnosed with first-trimester missed abortion and treated with ۸۰۰ micrograms of vaginal misoprostol between April ۲۰۱۴ and March ۲۰۱۵. Data were collected on maternal age, gravidity, dosing interval, and treatment outcomes. The primary outcome was treatment success, defined as resolution of the missed abortion without the need for dilation and curettage (D&C), including cases that required evacuation and curettage (E&C) for incomplete expulsion. Treatment failure was defined as requiring D&C.Results: Of ۴۹۲ patients, ۴۷۰ (۹۵.۵%) had successful medical management without the need for D&C. Treatment failure occurred in ۲۲ women (۴.۵%). Among non-responders, most were aged ۳۰–۳۸ years (۴۰.۹%) and multigravida (۹۰.۹%). In the failure group, ۴۵.۵% had received misoprostol every ۸ hours and ۵۴.۵% every ۳ hours. No complications such as hemorrhage, infection, or uterine rupture were recorded. The observed failure rate (۴.۵%) was lower than those reported in studies from Mumbai (۸.۷%) and Pakistan (۱۰%).Conclusion: Vaginal misoprostol demonstrated high efficacy and an excellent safety profile for the management of first-trimester missed abortion at Rabia Balkhi Hospital. The effectiveness observed in this cohort exceeds that reported in regional studies. Further research is warranted to optimize dosing protocols and identify factors associated with treatment failure in similar resource-limited settings.Background: Misoprostol is widely used for the medical management of missed abortion, but response rates vary across settings. We evaluated the efficacy of ۸۰۰ mcg vaginal misoprostol for first-trimester missed abortion at Rabia Balkhi Hospital, Kabul, Afghanistan. Methods: This retrospective case series included ۴۹۲ women diagnosed with first-trimester missed abortion and treated with ۸۰۰ micrograms of vaginal misoprostol between April ۲۰۱۴ and March ۲۰۱۵. Data were collected on maternal age, gravidity, dosing interval, and treatment outcomes. The primary outcome was treatment success, defined as resolution of the missed abortion without the need for dilation and curettage (D&C), including cases that required evacuation and curettage (E&C) for incomplete expulsion. Treatment failure was defined as requiring D&C. Results: Of ۴۹۲ patients, ۴۷۰ (۹۵.۵%) had successful medical management without the need for D&C. Treatment failure occurred in ۲۲ women (۴.۵%). Among non-responders, most were aged ۳۰–۳۸ years (۴۰.۹%) and multigravida (۹۰.۹%). In the failure group, ۴۵.۵% had received misoprostol every ۸ hours and ۵۴.۵% every ۳ hours. No complications such as hemorrhage, infection, or uterine rupture were recorded. The observed failure rate (۴.۵%) was lower than those reported in studies from Mumbai (۸.۷%) and Pakistan (۱۰%). Conclusion: Vaginal misoprostol demonstrated high efficacy and an excellent safety profile for the management of first-trimester missed abortion at Rabia Balkhi Hospital. The effectiveness observed in this cohort exceeds that reported in regional studies. Further research is warranted to optimize dosing protocols and identify factors associated with treatment failure in similar resource-limited settings.

کلیدواژه ها:

Missed abortion ، Misoprostol ، Medical management ، Afghanistan