Published: 2022-01-28

Comparison of efficacy of 600 and 800 micrograms vaginal misoprostol in early pregnancy failure in SMGS: a tertiary health care hospital in Jammu, India

Reema Khajuria, Arushi Suri, Rohini Jaggi


Background: Misoprostol use in early pregnancy failure is varied and dose is not well established. Aim of this study was to compare efficacy and side effects of 600 versus 800 micrograms vaginal misoprostol in early pregnancy failure.

Methods: A randomized prospective observational study was conducted in the postgraduate department of obstetrics and gynaecology, SMGS hospital Jammu from November 2018 to October 2019 after getting approval from the ethical committee. Hundred patients (50 in group A and 50 in group B) admitted in labour room before 12 weeks of gestation with an ultrasound diagnosis of early fetal demise (missed abortion or brightened ovum) were treated medically with different doses of vaginal misoprostol.

Results: The success rate in patients in group A is 72% and group B is 88%, p=0.045 (difference is statistically significant). Patients who required suction and evacuation were 28% in group A and 12% in group B.

Conclusions: Use of misoprostol for medical management of 1st trimester missed/anembryonic is an effective, cheap, safe and convenient alternative to surgical evacuation. It was concluded that 800 micrograms vaginal misoprostol is more effective than 600 micrograms vaginal misoprostol. But 800 micrograms misoprostol has more side effects than 600 micrograms vaginal misoprostol.


Misoprostol, Missed abortion, Early pregnancy failure

Full Text:



Warburton D, Fraser FC. Spontaneous abortion risks in man: data from reproductive histories collected in a medical genetics’ unit. Am J Hum Genet. 1964;16:1-25.

Pridjian G, Moawad A. Missed abortion: still appropriate terminology. Am J Obstet Gynecol. 1989;161:261-2.

Hertig AT, Livingstone RG. Spontaneous, threatened and habitual abortion: their pathogenesis and treatment. N Engl J Med. 1944;26:797-806.

Hughes J, Ryan M, Hinshaw K, Henshaw R, Ripsin R, Templeton A. The costs of treating miscarriage: A comparison of medical and surgical management. Br J Obstet Gynaecol. 1996;103:1217-21.

Couzinet B, Le strat N, Ulman A, Baulieu EE, Schaison G. Termination of early pregnancy by the progesterone antagonist RU486 (mifepristone). N Engl J Med. 1986;315(25):1565-70.

Norman JE, Thong KJ, Baird DT. Uterine contractility and induction of abortion in early pregnancy by misoprostol and mifepristone. Lancet. 1991;338:1233-6.

Barbosa RM, Arilha M. The Brazilian experience with cytotec studies in family planning. Stud Fam Plann 1993 24(4):236-40.

Coelho HL, Teixeria AC, Santos AP, Forte EB, Morais SM, La Vecchia C et al. Misoprostol and illegal abortion in Fortaleza Brazil. Lancet. 1993;341(8855):1261-3.

El Rafaey H, Calder L, Wheatley DN, Templeton A. Cervical priming with prostaglandin E1 analogues, misoprostol and gemeprost. Lancet. 1994;343:1207-9.

National institute for Health and Care Excellence guidelines. Ectopic pregnancy and miscarriage: diagnosis and initial management. 2012.

Prasartsakulchai C, Tannirandorn Y. A comparison of vaginal misoprostol 800 microg versus 400 microg in early pregnancy failure: a randomized controlled trial. J Med Assoc Thai. 2004;87:S18-23.

Seervi N, Hooja N, Rajoria L, Verma A, Malviya K, Mehta N. comparison of different regimens of misoprostol for the termination of early pregnancy failure. Med J Armed Forces India. 2014;70(4):360-3.

Srikhao N, Tannirandorn Y. A comparison of vaginal misoprostol 800 microg versus 400 microg for anembryonic pregnancy: a randomized control trial. J Med Assoc Thai. 2005;88(2):S41-7.

Hooja N, Servi N, Mital P. Efficacy of vaginal Misoprostol in termination of early pregnancy failure. Sch Acad J Biosci. 2014;2(9):570-2.

Anita S, Anand S. A study of vaginal misoprostol for medical management of missed abortion upto 12 weeks of gestation. IOSR-JDMS. 2016;15(4):7:83-6.

Barcelo F, De Paco C, Lopez-Epsin JJ, Silva Y, Abad L, Parilla JJ. The management of missed miscarriage in an outpatient setting: 800 versus 600 mcg of vaginal misoprostol. Aust N Z J Obstet Gynaecol. 2012;52(1):39-43.

Kovakisarach E, Jamnasiri C. Intravaginal misoprostol 600 µg and 800 µg for the treatment of early pregnancy failure. Int J of Gynecol and Obst. 2005;90(3):208-12.

Aryes de Campos D, Teixeira-da-Silva J, Campos I, Patricio B. Vaginal misoprostol in the management of first trimester missed abortions. Int J Gynaecol Obstet. 2000;71(1):53-7.

Thakur S, Pratap C. Comparison between sublingual 600 and 800 micrograms misoprostol after mifepristone for MTP up to 9 weeks gestation. Int J Reproduct Contracep Obstetr Gynecol. 2018;7(12):4996-5004.