COMPARISON OF MISOPROSTOL AND MANUAL VACUUM ASPIRATION FOR THE MANAGEMENT OF INCOMPLETE MISCARRIAGE: A RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: To compare the effectiveness and safety of misoprostol with manual vacuum aspiration (MVA) for the management of incomplete miscarriage.

Methods: This randomized controlled trial was conducted in the Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital Rawalpindi. One hundred twenty women with incomplete miscarriage were randomized to receive either misoprostol (Group A, n=60) or MVA (Group B, n=60). Treatment success, adverse effects, and hospital stay were recorded.

Results: Complete uterine evacuation occurred in 86.7% of the misoprostol group versus 98.3% in the MVA group (p=0.02). Gastrointestinal side effects (nausea, vomiting, diarrhea) were more frequent with misoprostol (40%) than MVA (11.7%) (p<0.001). Hospital stay was longer with misoprostol (1.8±0.6 days) than MVA (0.5±0.2 days) (p<0.001).

Conclusion: Both methods were effective, but MVA achieved a higher success rate with shorter hospital stay and fewer gastrointestinal side effects. Misoprostol remains a reasonable option where surgical services are limited or patient preference favors medical management.1,6