Incomplete miscarriage: a randomized controlled trial comparing oral with vaginal misoprostol for medical evacuation

BACKGROUND: A prospective randomized controlled trial was conducted to compare the efficacy and side-effects of vaginal versus oral misoprostol in the medical management of incomplete miscarriage. METHODS: Two hundred and one patients who miscarried consented to randomization using computer-generated randomization model prior to treatment. A total of 800 mug of misoprostol was given either vaginally or orally to the randomized subjects. A second dose was repeated 4 h later if the product of conception had not been passed. RESULTS: The incidence of complete uterine evacuation following vaginal and oral misoprostol was similar [(58/95) 61.1 % versus (67/103) 64.4%]. There was a significantly decreased incidence of diarrhoea [(12/95) 13.6% versus (62/103) 65.3%, P < 0.01] with the use of vaginal misoprostol. CONCLUSIONS: Vaginal misoprostol was as effective as oral misoprostol in medical uterine evacuation in patients with incomplete miscarriage. There was also a reduction in the incidence of diarrhoea with the use of vaginal misoprostol.