@article{3134580,
    title = "High-dose misoprostol used in outpatient management of first trimester spontaneous abortion",
    author = "Sifakis, S. and Angelakis, E. and Vardaki, E. and Fragouli, Y. and Koumantakis, E.",
    journal = "Archives of Gynecology and Obstetrics",
    year = "2005",
    volume = "272",
    number = "3",
    pages = "183-186",
    issn = "0932-0067, 1432-0711",
    doi = "10.1007/s00404-004-0697-8",
    keywords = "misoprostol, adult;  article;  chill;  conception;  diarrhea;  drug efficacy;  drug induced headache;  drug megadose;  drug safety;  drug tolerability;  female;  fever;  first trimester pregnancy;  human;  infection;  major clinical study;  missed abortion;  nausea;  outpatient care;  pregnancy disorder;  spontaneous abortion;  uterus bleeding;  vomiting, Abortifacient Agents, Nonsteroidal;  Abortion, Missed;  Administration, Intravaginal;  Adolescent;  Adult;  Dose-Response Relationship, Drug;  Drug Administration Routes;  Female;  Humans;  Misoprostol;  Outpatients;  Pregnancy;  Pregnancy Trimester, First;  Treatment Outcome",
    abstract = "Aim: The aim of this study was to evaluate the efficacy and tolerance of a high dose of vaginal misoprostol for outpatient medical management of missed abortion. Methods: Three doses of 400 μg misoprostol were administered intravaginally every 4 h daily, for a maximum period of 3 days, to 108 women with uneventful first trimester pregnancy failure. Results: A total of 98 women (90.7%) were managed successfully, with 74 (68.5%) of them within the first 24 h. The mean dose of misoprostol administered was 1,113.0 μg (range 400-3,600 μg), and the mean time required was 19.5 h (range 7-65 h). Only 6 out of 108 women (9.3%) required surgical intervention as the result of retained products of conception. The side effect profile was minimal. Conclusion: This protocol of 400 μg intravaginally misoprostol every 4 h as three daily doses for a maximum of 3 days, may offer an efficacious and safe alternative to the outpatient management of first-trimester missed abortion. © Springer-Verlag 2005."
}