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A Comparison of Outpatient Treatment of Three Medical Groups with Fetal Death in the First Trimester of Pregnancy during the COVID-19 Pandemic: A Randomized, Controlled, Double-Blind Clinical Trial
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  • Athar Rasekh Jahromi,
  • Reza Shahriarirad,
  • Ali Masoudi,
  • Zahra Zarei babaarabi,
  • Nikta Taghipour
Athar Rasekh Jahromi
Jahrom University of Medical Science

Corresponding Author:[email protected]

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Reza Shahriarirad
Shiraz University of Medical Sciences
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Ali Masoudi
Yazd University of Medical Science
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Zahra Zarei babaarabi
Jahrom University of Medical Science
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Nikta Taghipour
Jahrom University of Medical Science
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Abstract

Objective: To evaluate the efficacy and side effects of each medication regime, a comparison was drawn between the administration of misoprostol with the combined use of misoprostol plus oxytocin and misoprostol plus methylergometrine for full expulsion of retained intrauterine tissues in patients who underwent a miscarriage. Design: randomized, double-blind, clinical trial Setting: gynecology and obstetrics clinic in Jahrom, Southern Iran Population: 90 patients with gestational age below 12 weeks and having undergone a recent miscarriage. Methods: They were randomly allocated into three groups after being screened for underlying diseases and coagulative blood disorders. For the first group, labeled as the control group, misoprostol was administered alone, while as, the combination of misoprostol plus methylergometrine and misoprostol plus oxytocin was prescribed for the second and third groups, respectively. Main Outcome Measures: Primary: Expulsion of retained products of conception; Secondary: Pain, Hemorrhage Results: Despite no significant statistical difference being observed in the expulsion of retained products of conception (RPOC)by the administration of misoprostol alone or with combined medical therapy of misoprostol with oxytocin or methylergometrine (P-value< 0.329), all of them showed a successful treatment. Additionally, the patients treated with misoprostol and oxytocin showed good results in expelling the RPOC(P=0.013); while as, those treated by misoprostol plus methylergometrine reported controlled pain and hemorrhage after an abortion (P=0.004). Conclusion: The course of medications viz. methylergometrine, oxytocin, and misoprostol indicated a successful outpatient treatment in patients that had experienced a miscarriage or an incomplete abortion. They are cost-effective and have shown lesser side effects.