Misoprostol for miscarriage management in a woman with previous five cesarean deliveries: a case report and literature review

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Abstract

Background

Misoprostol is an effective medical method for the management of pregnancy loss. However, data on its efficacy and safety in women with previous cesarean deliveries are limited.

Case presentation

We report a 36-year-old patient, gravida 11 para 6, with a diagnosis of missed miscarriage at 15 weeks of gestation. The patient had a significant obstetric history of previous five cesarean deliveries and uterine rupture. Following patient counseling about the medical and surgical options of managing her miscarriage, the patient opted for medical method. Low-dose misoprostol of 100 µg was inserted vaginally and repeated again after 6 hours. The patient had an uneventful complete miscarriage following the second dose of misoprostol. No uterine rupture, no extra vaginal bleeding, and no blood transfusion were observed.

Conclusion

We conclude that adopting a low-dose misoprostol protocol could be potentially safe and effective in managing second trimester missed miscarriage in women with repeated cesarean deliveries and/or uterine rupture history. Further studies are needed to confirm these results.

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Author and article information

Journal

Journal ID (nlm-ta): Ther Clin Risk Manag

Journal ID (iso-abbrev): Ther Clin Risk Manag

Journal ID (publisher-id): Therapeutics and Clinical Risk Management

Title: Therapeutics and Clinical Risk Management

Publisher: Dove Medical Press

ISSN (Print): 1176-6336

ISSN (Electronic): 1178-203X

Publication date Collection: 2017

Publication date (Electronic): 09 May 2017

Volume: 13

Pages: 625-627

Affiliations

[1 ]Department of Pharmacy, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar

[2 ]Public Health Program, London School of Hygiene and Tropical Medicine, University of London, UK

[3 ]Department of Obstetrics and Gynecology, Women’s Hospital

[4 ]Clinical Support Service Unit, Hamad Medical Corporation, Doha, Qatar

[5 ]Pharmacy and Life Sciences Research Institute, Robert Gordon University, Aberdeen, Scotland

Author notes

Correspondence: Doua AlSaad, Department of Pharmacy, Women’s Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar, Tel +974 44 39 3340, Fax +974 44 39 3867, Email alsaad.doua@ 123456gmail.com

Article

Publisher ID: tcrm-13-625

DOI: 10.2147/TCRM.S132294

PMC ID: 5431700

PubMed ID: 28533686

SO-VID: 1a346b5d-e49b-4862-9df1-ea0e6f4cefa1

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.