Medical treatment of spontaneous abortion in the first trimester

Objectives: To evaluate the efficacy of medical treatment with misoprostol in spontaneous abortion in the first trimester; to determine the incidence of adverse effects and complications and identify causes that may lead to the failure of medical treatment; to identify the acceptability of the treatment, patient acceptance and patient satisfaction; and to perform a cost-effectiveness analysis. Subjects and methods: A longitudinal, observational, prospective, descriptive and analytic study was performed in 680 patients diagnosed with spontaneous abortion in the first trimester between June 2009 and December 2011 at the Hospital Clinico San Carlos. A protocol was developed for medical treatment with misoprostol administration for patients who accepted to undergo this treatment rather than classical surgery. Results: The success of medical treatment was 81.85%. The treatment was effective in 89.21% of incomplete abortions, in 79.52% of missed abortions, and in 78.46% of anembrionic pregnancies. Minor adverse effects occurred in 33.59% of the patients, and 84.99% of the patients reported they were satisfied. Medical treatment produced a cost saving of (sic) 960.54 per patient. Conclusions: The success of medical treatment in our study was high, with misoprostol administration being effective in approximately 8 out of 10 patients. Misoprostol is highly accepted by patients and most reported that they were satisfied. The incidence of minor adverse effects was low, and these effects were well tolerated; consequently, their presence does not seem to restrict the application of this treatment. Misoprostol use helps to reduce healthcare costs. (C) 2013 Elsevier Espana, S.L. All rights reserved.