COMPARISON OF INTRACERVICAL LAMINARIA PLUS VAGINAL MISOPROSTOL AND VAGINAL MISOPROSTOL ONLY WITH VARIABLE DOSAGES FOR MEDICAL ABORTION WITHIN 12 HOURS
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초록
Objective To compare the effectiveness of intracervical laminaria plus vaginal misoprostol and vaginal misoprostol only with variable dosages by analyzing the rate of spontaneous gestational sac expulsion for medical abortion within 12 hours. Methods This study was performed in 94 patients for missed abortion at Department of Obstetrics and Gynecology, St. Paul’s Hospital, the Catholic University of Korea for 5 years (2004-2008). Forty seven patients were managed with laminaria insertion and intravaginal misoprostol 200 μg, 400 μg, or 800 μg at admission or outpatient clinic. The others were treated with only misoprostol at the same dose. We analyzed the rate of spontaneous expulsion of gestational sac within 12 hours. Results In non-laminaria group, spontaneous expulsion rate increased according to the doses of misoprostol (4.2%, 37.5%, and 33.3%, in 200 μg, 400 μg, and 800 μg, respectively, P =0.028). Between groups with the same misoprostol doses, no difference was observed in the spontaneous expulsion of the fetal sac within 12 hours according to the use of laminaria. On multivariate logistic regression analysis, factors that were associated signifi cantly and independently with spontaneous expulsion of conceptus were misoprostol ≥400 μg and gestational age. Conclusion Treatment of missed abortion with 400 or 800 μg misoprostol vaginally is safe and acceptable method, and reduced the number of surgical interventions.
Abstract
Objective To compare the effectiveness of intracervical laminaria plus vaginal misoprostol and vaginal misoprostol only with variable dosages by analyzing the rate of spontaneous gestational sac expulsion for medical abortion within 12 hours. Methods This study was performed in 94 patients for missed abortion at Department of Obstetrics and Gynecology, St. Paul’s Hospital, the Catholic University of Korea for 5 years (2004-2008). Forty seven patients were managed with laminaria insertion and intravaginal misoprostol 200 μg, 400 μg, or 800 μg at admission or outpatient clinic. The others were treated with only misoprostol at the same dose. We analyzed the rate of spontaneous expulsion of gestational sac within 12 hours. Results In non-laminaria group, spontaneous expulsion rate increased according to the doses of misoprostol (4.2%, 37.5%, and 33.3%, in 200 μg, 400 μg, and 800 μg, respectively, P =0.028). Between groups with the same misoprostol doses, no difference was observed in the spontaneous expulsion of the fetal sac within 12 hours according to the use of laminaria. On multivariate logistic regression analysis, factors that were associated signifi cantly and independently with spontaneous expulsion of conceptus were misoprostol ≥400 μg and gestational age. Conclusion Treatment of missed abortion with 400 or 800 μg misoprostol vaginally is safe and acceptable method, and reduced the number of surgical interventions.
참고문헌 (22)
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