Misoprostol for uterine evacuation in patients with early pregnancy failures

Objective The purpose of this study was to evaluate the effectiveness of misoprostol that is administered intravaginally for uterine evacuation in patients with early pregnancy failures. Study design From March 2001 through March 2003, we treated 41 patients who had early pregnancy failures with vaginal misoprostol, 800 μg. A second course of misoprostol was administered if uterine evacuation did not occur in 24 hours. Patients who had no response to misoprostol underwent a surgical curettage. Our principal outcome measures were the percentage of patients who had successful evacuation of the products of conception and the frequency of adverse drug effects. Results Twenty-six patients had successful uterine evacuation with a single course of misoprostol; 6 patients required a second course. The overall success rate was 78% (95% CI, 63, 88). No patient experienced a serious adverse drug effect. Conclusion Intravaginal misoprostol is a safe, effective alternative to surgical curettage for the treatment of early pregnancy failure.