Creinin M D, Moyer R, Guido R
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pennsylvania, USA.
Obstet Gynecol. 1997 May;89(5 Pt 1):768-72. doi: 10.1016/s0029-7844(97)81438-x.
To determine whether misoprostol (a prostaglandin E1 analogue) 400 micrograms orally (group 1) or 800 micrograms vaginally (group 2) will cause complete uterine evacuation in women with early pregnancy failure.
Twenty subjects were recruited for a prospective, non-blinded, randomized clinical trial. Early pregnancy failure was diagnosed by transvaginal ultrasound examination; only women with a closed cervical os and minimal vaginal bleeding were enrolled. Subjects returned 24 hours after misoprostol administration for a transvaginal ultrasound examination. If the gestational sac was still present, the misoprostol dose was repeated and the subject returned again 24 hours later. Subjects who failed to expel the pregnancy were offered a suction curettage.
Twelve and eight women were randomized to groups 1 and 2, respectively. Complete uterine evacuation occurred in three of 12 [25%, 95% confidence interval (CI) 1%, 50%] and seven of eight (88%, 95% CI 65%, 100%, P = .010) subjects in groups 1 and 2, respectively. Vomiting occurred in 30% and 13%, respectively, and diarrhea in 50% and 38%, respectively.
Vaginal misoprostol 800 micrograms is more effective than oral misoprostol 400 micrograms for uterine evacuation of early pregnancy failure and may be an effective alternative to dilation and curettage.
确定口服400微克米索前列醇（一种前列腺素E1类似物，第1组）或阴道给予800微克米索前列醇（第2组）是否会使早期妊娠失败的女性完全排空子宫。
招募20名受试者进行一项前瞻性、非盲法、随机临床试验。通过经阴道超声检查诊断早期妊娠失败；仅纳入宫颈口闭合且阴道出血极少的女性。受试者在服用米索前列醇24小时后返回进行经阴道超声检查。如果妊娠囊仍存在，则重复米索前列醇剂量，并在24小时后再次返回。未能排出妊娠物的受试者接受吸刮术。
分别有12名和8名女性被随机分配到第1组和第2组。第1组12名受试者中有3名（25%，95%置信区间[CI] 1%，50%）、第2组8名受试者中有7名（88%，95% CI 65%，100%，P = 0.010）完全排空子宫。呕吐发生率分别为30%和13%，腹泻发生率分别为50%和38%。
800微克阴道用米索前列醇在早期妊娠失败的子宫排空方面比400微克口服米索前列醇更有效，可能是扩张刮宫术的有效替代方法。
