Efek Misoprostol Sublingual pada Kasus Blighted Ovum dan Missed Abortion

Abstract

Background: Misoprostol, a prostaglandin E1 analog is widely used especially during first and second trimester as a cervical ripening before curretage as well as medical abortion without curretage. Misoprostol dosage and mode of administration are still an interesting study. Sublingual administration of misoprostol needs further study. Objective: To evaluate the effect and side effect of repeated dosage of 400 􀁐g misoprostol administered sublingually at four-hourly interval up to a maximum of two doses in total for the treatment of blighted ovum and missed abortion. Methods: A pseudo clinical trial was done to all patients diagnosed to have blighted ovum and missed abortion coming to Dr. Kariadi Hospital between March and July 2005. Patients were given sublingual 400 􀁐g misoprostol. Evaluation were done every 4 hours toward blood pressure, heart rate and body temperature and other major complaints. Descriptive analysis was carried to the available data. Results: Mean time interval between drug administration and uterine contraction achieved for 187.5 (115.4) minutes. Mean time interval of drug administration and the expulsion of product of conception achieved for 300.6 (118.5) minutes. Cervical dilatation in patient with no product of conception expulsion were 9.1 (1.3) mm and median 9.0 (range: 7-12) mm. Sublingual misoprostol found to dilate a cervix without expulsion of product of conception in 51.4% of subject and expulsion of product of conception in 48.6% with side effect of shivering in 11.4%, headache 8.6%, nausea 5.7% and vomiting 2.9%. Conclusion: Sublingual misoprostol dilates cervix with and without product of conception expulsion and gives mild side effect.