OUTCOME MEASURE AFTER USE OF MISOPROSTOL FOR MEDICAL TERMINATION OF MISCARRIAGE

Objective: To determine the outcome measure after use of misoprostol for medical termination of miscarriage Material and Methods: This prospective observational study carried out at Ibri Regional Hospital Oman from September 2015 to February 2016. All women who had missed or incomplete miscarriage and received tablet misoprostol course for medical termination as per hospital protocol were selected.All patients received 400 micro gm of tab misoprostol stat (1 tab orally and 1 tab per vaginally), and then subsequent 800 micro gm tab misoprostol received orally in 4 divided doses. All patient had sonographic surveillance before and after misoprostol course. After completion of misoprostol course, scan repeated at least 4-6 hours after the last dose.The cutoff value of ultra-sonographic endometrial thickness for complete miscarriage taken 12-14 mm homogenous in nature.Upon discharge from the hospital, every patient called after 2 weeks for follow up and endometrial thickness was measured by ultrasound. Results: Mean age of the patients in this study was 32.4±5.9. Mean gestational age of the patients was 11.3±3.3. 64(47.8%) patients had history of previous miscarriage and 41(30.6%) patients had previous history of D &C. 17(12.7%) patients had co morbidities while mean hemoglobin level was 11.5±1.1. In this study, 80(59.7%) patients presented with bleeding. Only 3(2.2%) had deranged coagulation profile. 20(14.9%) patients had post misoprostol bleeding and 2(1.5%) had fever.82(61.2%) patients report confirmed product of conception, in 3(2.2%) report product of conception not found and in 49(36.6%). Mean ± SD of Pre misoprostol endometrial thickness was 17.5±4.4mm, while of Post misoprostol Endometrial thickness was 12.1±3.1mm and after 2 weeks was 7.62±1.7.Misoprostol showed significant good efficacy out of 134 patients significant success rate was found 60.4% (p=0.002). Conclusion: In the conclusion of this study misoprostol showed significant good success rate in the termination of miscarriage with less complications and short time of interval. Key Words: Misoprostol, medical termination, miscarriage