Efficacy of Misoprostol Alone or in Combination with Tamoxifen for Missed Miscarriage | ||
| Al-Azhar University Journal of Medical and Virus Researches and Studies | ||
| Volume 6, Issue 3, September 2024, Pages 136-146 PDF (251.73 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/aujv.2024.428530 | ||
| Abstract | ||
| Missed abortion, occurs in 15%–20% of clinically diagnosed pregnancies and it is a gestational sac containing a dead embryo or fetus before 24 weeks of gestation and retention of pregnancy products in the uterus for several days or weeks after death of the fetus, the cervix is closed and there is no or only slight bleeding. This study aims to evaluate the efficacy and safety of misoprostol alone versus tamoxifen with misoprostol for medical termination of first trimester missed miscarriage. This randomized control trial for ladies who attended Sohag general hospitals and Al-Zahraa University hospital for induction of abortion. The study including 120 cases, is divided into two groups. Group I includes 60 women and will receive misoprostol 800 mcg (2 sublingual tablets) and (2 vaginal tablets) starting dose. Then 400 mcg (2 sublingual tablets) every 4 hours (maximum 3 doses). Group II includes 60 women and will receive tamoxifen 60 mg daily for 3 days then misoprostol with a regimen similar to group I. 35 % of women in group II had complete abortion after tamoxifen use without misoprostol administration with high significant difference compared to group I (p<0.001). There was no statistically significant difference between the two groups as regards surgical evacuation. There was high significant difference between the two groups regarding bleeding (less in group II with p<0.001). There was significant increase in post abortive hemoglobin level in succeeded cases compared to failed cases in both group I & group II (p<0.001). Group II showed significant decrease in the degree of pain (visual analogue scale VAS) pain scale. There were no significant differences between studied cases in terms of age, gestational age, BMI, base line hemoglobin. (p>0.05). Tamoxifen with misoprostol is very effective in first trimester pregnancy termination with 86.7 % rate of complete abortion with less side effects. So, we recommend its use as a first line medical method in first trimester pregnancy termination as it is rapid and safe. | ||
| Keywords | ||
| Misoprostol; Tamoxifen; Miscarriage | ||
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