Abstract
ABSTRACT
The objective was to assess the feasibility of nonsurgical evacuation of first trimester pregnancy wastage. A randomized control trial involving three groups: (1) dilatation and curettage (D&C) only, (2) intramuscular prostaglandin methyl-F2a, 500 μg in a single injection (PGmF2α, 500 μg IM), (3) oral Trilostane, 120 mg every 6 hours on four occasions, together with PGmF2α, 500 μg IM administered with the third trilostane dosage. Sixteen patients were referred to the Coombe Hospital and diagnosed ultrasonographically as having an incomplete miscarriage or missed abortion of < 12 weeks gestation. Treatment failures were subjected to D&C. The main outcome measures included the number of complete evacuations diagnosed ultrasonographically, analgesic requirements, side effects, and symptoms at 6 weeks after treatment. Using a reduction in uterine cavity surface area to < 6 cm2 as success following treatment, complete evacuation occurred in 100% of women treated with Trilostane and prostaglandin, 50% of women treated with prostaglandin only, and 40% of women treated by D&C only. The combination of Trilostane and prostaglandin is very effective in evacuating first trimester incomplete miscarriage or missed abortion. However, further dosage refinements are necessary to minimize prostaglandin side effects. (J GYNECOL SURG 8:159, 1992)
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