•  
  •  
 

Abstract

ABSTRACT: BACKGROUND: Missed abortion refers to a pregnancy that can manifest as an anembryonic gestation or fetal demise prior to 20 weeks' gestation. Medical management has been used as a treatment options.A common medical regimen used to evacuate the uterus is vaginal misoprostol (Cytotec) in single or multiple doses. OBJECTIVE: To compare the therapeutic efficacy and adverse effects of intravaginal administration of a nitric oxide donor (glyceryl trinitrate) with that of a prostaglandin (misoprostol) to induce cervical changes in women with missed miscarriages to terminate their pregnancies. METHODS: A prospective, randomized comparative trial conducted at Al-Yarmouk Teaching Hospital, Department of Obstetrics & Gynaecology/ Baghdad-Iraq, enrolled Sixty women with first trimester missed miscarriages that requested pregnancy termination. They were randomly selected to receive either two tablets of 500 μg glyceryl trinitrate vaginally (n = 30) or 200 μg misoprostol tablet vaginally (n = 30), every 3 hours to a maximum of four doses or until reaching desirable cervical changes. Baseline vital signs were recorded and repeated with monitoring for adverse side effects every 3 hours until finishing therapy. RESULT: The difference in cervical changes between the two groups was statistically not significant (p > 0.05). The successful outcome taken as cervical dilatation ≥ 10 mm, incomplete, or complete miscarriage was achieved in 30% of women in the glyceryl trinitrate and in 53% of women in the misoprostol group which was statistically not significant ( p>0.05). Systolic & diastolic blood pressure, temperature & heart rate were lower with glyceryl trinitrate than misoprostol, but the differences were not significant (p>0.05).The most frequent side effect associated with glyceryl trinitrate administration was headache, which occurred in 27/30 women, compared with only 5/30 women in misoprostol group; relative risk 5.42 (p

Download

Share

COinS