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
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.