Medical versus surgical methods for termination of first trimester miscarriage: A comparative Study

Document Type : Original Article

Authors

1 Department of Gynecology and Obstetrics, Assiut University Hospitals

2 Department of Gynecology and Obstetrics, Faculty of Medicine, Assiut University, Assiut, Egypt

3 Obstetrics and gynecology department faculty of medicine Assuit University

Abstract

Background: Worldwide, induced abortions are among the most frequently performed operations. Surgical abortion has been around for a while, but in the past 10 years, many new medical abortion treatments have emerged. Early miscarriages can be managed through medical or surgical methods. This study was set out to evaluate the efficacy of surgical evacuation versus vaginal misoprostol tablets in preventing miscarriage during the first trimester of pregnancy.
Methods: This comparative research was conducted on 180 patients, inevitable, incomplete and missed miscarriage. Most medically treated patients used different random doses and methods of administering misoprostol, often concluding treatment at home with follow-up phone calls. While in surgical group, patients received saddle anesthesia, and the size of their uterus was assessed via bimanual examination. After the surgery, patients were discharged within six hours and prescribed prophylactic antibiotics.
Results: The two groups' medical records differed significantly. There was a notable variation in the groups based on the type of labor. The effect of medical factors was significantly different for gestational age determined by last menstrual period. The type of intervention had a significant impact on endometrial thickness as measured by ultrasound and medical data, with a p-value less than 0.05. There were moderate significant differences between the effect of medical treatment with the response with a higher percentage of response in treatment oral +vaginal (92.2%) and (91.7%) in treatment vaginal +sublingual.
Conclusions: Surgical termination of first-trimester miscarriage is superior to medical termination (97.9%). The success of medical termination of first-trimester miscarriage is predictable with gestational age <10 weeks, normal Laboure, High dose of misoprostol and with missed abortion.

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