Medical treatment of miscarriage using Misoprostol - a retrospective study

Abstract Purpose The treatment of early miscarriage with medication is effective and low in side effects. Nevertheless, no uniform dosage regimen has yet been established, nor has it been possible to determine whether previous pregnancies and births with their respective modes of delivery play a role in the effectiveness of Misoprostol. This study aimed to find predictive parameters for successful treatment with Misoprostol in early miscarriage. Methods In a retrospective study at the OVG University Women's Hospital, records of patients with early miscarriage and medical treatment using Misoprostol from 2018-2021 were reviewed for this purpose. The need for a curettage subsequent to treatment was scored as a parameter of failure. The data was analyzed using Statistical Package for the Social Science Version 28.0 (SPSS). The significance level was set to 0.050. Results We found that successful therapy with misoprostol was seen in 86% (n=114). 14% (n=20) of the patients had curettage after taking Misoprostol as advised. Out of 156 women, 19% (n=30) reported mild side effects, with nausea as the leading one (12.2% (n=19)). Significance was found comparing the measurement of double endometrial stripe thickness after the second cycle of Misoprostol in women with and without curettage after medical treatment (exact value two-sided 0.012 at p<0.05). Conclusion Our results indicate that treatment of early miscarriage in the first trimester with Misoprostol is effective and has few side effects. The measurement of the endometrial stripe thickness after the second cycle of Misoprostol via transvaginal ultrasound could present a predictive marker during therapy.