International Journal of Gynecology & Obstetrics
Volume 99, Supplement 2 , Pages S182-S185, December 2007

Misoprostol to treat missed abortion in the first trimester

  • K. Gemzell-Danielsson

      Affiliations

    • Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet/Karolinska University Hospital, Stockholm, Sweden
    • Corresponding Author InformationCorresponding author. Karolinska University Hospital, Department of Woman and Child Health, Division for Obstetrics and Gynaecology, P.O. Box 140, S-171 76 Stockholm, Sweden. Tel.: +46 8 517 721 28; fax: +46 8 517 743 14.
    • ,
  • P.C. Ho

      Affiliations

    • Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong Special Administrative Region
    • ,
  • R. Gómez Ponce de León

      Affiliations

    • Ipas and School of Public Health, UNC at Chapel Hill, Chapel Hill, NC, USA
    • ,
  • A. Weeks

      Affiliations

    • School of Reproductive and Developmental Medicine, University of Liverpool, Women's Hospital, Liverpool, UK
    • ,
  • B. Winikoff

      Affiliations

    • Gynuity Health Projects, New York, NY, USA

published online 04 October 2007.

Recommended Dosages

Vaginal misoprostol 800 μg OR sublingual misoprostol 600 μg

Abstract 

Missed abortion in the first trimester is characterized by the arrest of embryonic or fetal development. The cervix is closed and there is no or only slight bleeding. Ultrasound examination shows an empty gestational sac or an embryo/fetus without cardiac activity. Based on a review of the published literature a single dose of 800 μg vaginal misoprostol may be offered as an effective, safe, and acceptable alternative to the traditional surgical treatment for this indication. Alternatively, 600 μg misoprostol can be administered sublingually. After administration of misoprostol, hospitalization is not necessary and the time to expulsion varies considerably. Bleeding may last for more than 14 days with additional days of light bleeding or spotting. The woman should be advised to contact a provider in case of heavy bleeding or signs of infection. A follow-up is recommended after 1 to 2 weeks.

Keywords: Anembryonic pregnancy, Missed abortion, Misoprostol

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PII: S0020-7292(07)00511-5

doi:10.1016/j.ijgo.2007.09.008

International Journal of Gynecology & Obstetrics
Volume 99, Supplement 2 , Pages S182-S185, December 2007

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