COMPARISON EFFICACY OF ORAL VERSUS VAGINAL MISOPROSTOL IN FIRST TRIMESTER INCOMPLETE MISCARRIAGE

Abstract

Background: First trimester incomplete miscarriage is a frequent obstetric complication that entails successful evacuation of the uterus to avoid infection and uterine bleeding. Prostaglandin E1-like compounds Misoprostol has been broadly employed by many methods of administration in medical management. Nevertheless, it is controversial how best the drug should be administered, that is, orally or vaginally, particularly in low-income countries. Objective: The study was a comparison of the oral Misoprostol versus vaginal Misoprostol in complete evacuation of uterus in females with incomplete miscarriage in the first trimester. Methods: It is a prospective comparative study, which started on June 2024 and ended on May 2025 at the Indus hospital and health network (IHHN). Ninety women with first trimester incomplete miscarriage were recruited and randomly divided into two groups where 45 women were offered 600 mcg of misoprostol by mouth, and other 45 women were offered 600 mcg of misoprostol intravaginally. Clinical examination and transvaginal ultrasono-graphy were used to reassess the uterus evacuation after 7 days. The secondary outcomes which included time taken to ensure bleeding stops, adverse effects, and satisfaction of the patients were also documented. Results: Full evacuation of the uterus occurred in 86.7 percent of the participants of the vaginal group and 71.1 percent of the people of the oral group. The opposite was significant statistically (p=0.04). Misoprostol taken vaginally was linked with fewer GI adverse effects whereas misoprostol administered orally led to the prompt appearance of hemorrhage. The vaginal group had a higher value of satisfaction since they experienced less adverse effects and perceived effectiveness. The infection rates or the necessity to remove surgically were not much different in the groups. Conclusion: Vaginal misoprostol proved to be much better than oral one in successful evacuation of the uterus as far as first trimester incomplete miscarriage. It also showed better side-effect profile and patient satisfaction, which implies that it could be the preferred medical management route towards such cases.

Keywords: Misoprostol, Incomplete miscarriage, First trimester, Oral administration, Vaginal administration, Uterine evacuation, Medical management.