Comparative Study Between Combined Vaginal Misoprostol (comparative)
Missed Abortion
About this trial
This is an interventional treatment trial for Missed Abortion
Eligibility Criteria
Inclusion Criteria:
- - Maternal Age 18 - 35 years.
- Gestational age first trimester of pregnancy (between 5-13 weeks).
- Missed abortion confirmed by ultrasound.
- Singleton pregnancy.
- Normal uterus and cervix on clinical examination.
- Cervix is not dilated.
- No vaginal bleeding.
Exclusion Criteria:- Evidences suggesting start of spontaneous abortion and previous trial to induce abortion.
- Presence of uterine contraction or bleeding,
- Multi-fetal pregnancy.
- Suspicion of septic abortion.
- History of Previous cervical surgery or manipulation. Ex: cervical tear , cervical cauterization .
- Uterine anomaly.
- Presence of IUD( intrauterine device) in situ
- Underlying medical diseases.Ex:diabetes mellitus,hypertension
- History of allergy or adverse effects to vaginally administered medication e.g. isosorbide -5- mononitrate
- Those unwilling to participate in the trial
- Higher order cesarean section(more than three
Sites / Locations
- Cairo U
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
patients who recieve misoprostol alone
patients who recieve misoprostol and iso sorbide mononitrate
Group A (n =30 ) will receive only vaginal Misoprostol 800mcg (4 tablets Cytotec 200mcg ) ) every 3 hours to a maximum of two doses or until reaching cervical ripening or uterine contractions or bleeding assessed by the same doctor who made evaluation at the beginning.
Group B (n =30 ) will receive combined vaginal Misoprostol 800mcg (4 tablets Cytotec ) ) every 3 hours to a maximum of two doses or until reaching cervical ripening or start of uterine contractions or bleeding. with Isosorbide-5-mononitrate (20 mg). Effox 20 mg )once at the beginning with misoprostol until reaching cervical ripening or start of and uterine contractions assessed by the same doctor who made the evaluation at the beginning.