Outpatient versus Inpatient Vaginal Misoprostol Administration for the First-trimester Abortion: A Randomized Clinical Trial
نویسندگان
1 a) Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran b) Family and the Youth of Population Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 a) Gynecologist, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran b) Family and the Youth of Population Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 a) Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran b) Family and the Youth of Population Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
4 a) Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran b) Family and the Youth of Population Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
5 Assistant Professor, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
doi
10.22038/jmrh.2023.65602.1915چکیده
Background & aim: Misoprostol is widely used for the first-trimester abortion. This study aimed to assess the success rate and side effects of outpatient versus inpatient vaginal misoprostol administration for the first-trimester abortion.Methods: A prospective randomized clinical trial included 280 women with first-trimester abortion (≤14 week’s gestation) referred to three educational hospitals of Mashhad University of Medical Sciences, Mashhad, Iran in 2019-2020. Patients were randomly assigned to receive vaginal misoprostol either in an inpatient or outpatients setting Intra-vaginal misoprostol 800-mcg was administered every twenty-four hours up to two doses. Treatment success, the primary outcome, was defined as complete evacuation after one or two doses. Elective curettage was performed if complete evacuation failed after one week, while emergent curettage was considered in cases of heavy vaginal bleeding. To analyse data, SPSS software (version 19.0) and Independent t-test, Chi-square test, and Logistic regression model was used. Results: Success rates for outpatient and inpatient treatments were 96.6% (114 out of 118) and 91.5%, (119 out of 130), respectively, showing no significant difference (P = 0.167). Additionally, side effects did not significantly differ between inpatient and outpatient groups (P = 0.698).Conclusion: Vaginal misoprostol (800-mcg every twenty-four hours for a maximum of two doses) in an outpatient setting is as effective as in an inpatient condition with similar side effects. Outpatient medical abortion can be a viable alternative to hospitalization.
