Vaginal Misoprostol More Effective Than Oral Route for Managing First-Trimester Missed Abortions: Meta-Analysis
Pakistan: A recent systematic review and meta-analysis comparing the oral and vaginal administration of misoprostol for managing first-trimester missed abortions has highlighted the superiority of the vaginal route in terms of both efficacy and safety. The findings were published online in the European Journal of Obstetrics & Gynecology and Reproductive Biology.
The analysis, which pooled data from multiple randomized controlled trials, found that vaginal misoprostol significantly outperformed the oral route in achieving complete abortion. Women who received the drug vaginally experienced a higher overall success rate of uterine evacuation without requiring surgical intervention. Additionally, the time between drug administration and complete expulsion—referred to as the induction-to-expulsion interval—was notably shorter in the vaginal misoprostol group.
Missed abortion during the first trimester refers to the situation where the embryo or fetus stops developing, but the cervix stays closed, and there is usually little or no bleeding. This condition is typically diagnosed through ultrasound, which may show an empty gestational sac or an embryo/fetus without a heartbeat. Misoprostol is commonly used to manage early pregnancy loss. Kanwal Majeed, Department of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan, and colleagues aimed to compare how effective misoprostol is when given orally versus vaginally in managing missed abortions in the first trimester.
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