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Article
Misoprostol for termination of first trimester missed abortion

Author: Maha Assim AL- Azzawy مها عاصم العزاوي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2009 Volume: 5 Issue: 7 Pages: 121-141
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background: misoprostol is prostaglandin E1 analogue that can be given by oral, sublingual, vaginal or rectal route. It is cheap and can be stored at room temperature and because of its utero-tonic action, it become an important drug in obstetric and gynecological practice.Objectives: to evaluate the effectiveness of intravaginal followed by oral misoprostol tablets for medical termination of missed abortion between 8 – 13 weeks.Methods : a prospective study of (60) women with diagnosed missed abortion admitted to AL- Zahraa General hospital – Wassit Governorate Iraq from July 2006 through July 2007 . 800 micrograms (4 tablets) of misoprostol inserted in the posterior fornix of the vagina after moisture with normal saline followed by oral 400 micrograms (2 tablets) 6 hours later. Another 400 micrograms were given orally 6 hours from the last dose for those patients whodid not respond to the previous two doses.Results: (48) patients (80%) had complete expulsion . (21) Patients (35%) after the vaginal dose. (15) Patients (25%) respond after the first oral dose and (12) patients (20%) after the second oral dose. (6) Patients (10%) had incomplete abortion; the remainder (6) patients (10%) failed to respond within 24 hours of starting treatment and require surgical evacuation. The mean time for expulsion was 10 hours. Conclusion: first trimester missed abortion medical termination by misoprostol is effective, save and a practical Methods .

الميزوبرستول هو مثيل البروستوكلاندين- اي 1 ويمكن ان يعطى عن طريق الفم وتحت اللسان و عن طريق المهبل وعن طريق الشرج. يعتبر هذا العقار رخيصا و ممكن خزنه في درجة حرارة الغرفه و بسبب فعاليته في احداث تقلصات رحميه اصبح عقارا مهما في مجال النسائيه و التوليد.الهدف من الدراسة هو لتقييم فعالية الميزوبرستول وذلك بأعطائه عن طريق المهبل يليه اعطائه عن طريق الفم لانهاء الاسقاط المنسي طبيا بين 8 – 13 اسبوع. هذهِ دراسه مستقبليه تضمنت ستون امرأه مشخصه بحالة اسقاط منسي ادخلوا مستشفى الزهراء العام في محافظة واسط / العراق للفتره بين تموز 2006 و تموز 2007 . 800 مايكروكرام ( اربع حبوب) من الميزوبرستول توضع في الجزء الخلفي من المهبل بعد ترطيبها بالنورمال سلاين تليها جرعه عن طريق الفم (400 مايكروكرام) بعد ستة ساعات . وجرعه فمويه اخرى بعد ستة ساعات من الجرعه الاخيره للمرضى الذين لم يستجيبوا للجرعتين الاوليتين.النتائج 48 مريضه (80%) حصل اسقاط كامل. 21 منهن(35%) بعد الجرعه الاولى. 15مريضه (25% ) بعد الجرعه الفمويه الاولى و 12 مريضه (20%) بعد الجرعه الفمويه الثانيه .6مريضات (10%) انتهوا بأسقاط ناقص و 6 مريضات (10%) لم يستجيبوا للعلاج بعد مرور 24 ساعه على بدأ العلاج واحتاجوا الى تداخل جراحي لانهاء الحمل. كان معدل وقت انهاء الاسقاط المنسي هو عشرة ساعات .يستنتج من الدراسة انهاء الحمل الطبي في حالات الاسقاط المنسي في الجزء الاول من الحمل بواسطة الميزوبرستول هي طريقه فعاله و امينه وعمليه.


Article
A STUDY OF SERUM MAGNESIUM AND CALCIUM LEVELS IN MISSED ABORTION

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Abstract

Background:Pregnancy is considered as a physiological stress, normal static metabolism of a woman is changed into dynamic anabolism, calcium (Ca) is the first most abundant cation in the human body, whereas magnesium (Mg) is the fourth most abundant one, role of calcium and magnesium in enzymatic activity of cell to release energy is well established.Objective:To assess the relation of serum magnesium and calcium levels in cases of missed abortion.Methods:Eighty two pregnant women at their 1st and 2nd trimester of pregnancy (before 24 completed weeks of pregnancy), 42 of them with missed abortion compared with 40 normal pregnancies served as a control group. Calcium analysis done using manual colorimetric method while magnesium analysis was done by magnesium calmogite method at the hospital laboratories.Results:Serum calcium was found to be insignificantly altered while serum magnesium was found to be significantly reduced in cases of missed abortion compared with normal pregnancy. Serum Ca/Mg ratio was found to be significantly elevated in cases of missed abortion compared with normal controls.Conclusion:Estimation of serum magnesium and Ca/Mg ratio in selected pregnancies can be valuable parameters for predicting missed abortion.Keywords:Missed abortion, Serum Calcium, Serum Magnesium.


Article
Role of Serum Progesterone in the Diagnosis of Ectopic Pregnancy and Missed Abortion

Authors: Abdulrazak H Alnakash --- Zeina Abdulsahib
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 1 Pages: 22-27
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: diagnosis of early pregnancy failure (ectopic pregnancy and missed abortion) still challenging even by using of serial B-HCG and ultrasound. Serum progesterone hormone level value is regarded as one of the important diagnostic tools in the diagnosis of many obstetrical and gynecological conditions; one of these is early pregnancy failure.OBJECTIVE: To assess the role of serum progesterone level in early diagnosis of ectopic pregnancy and missed abortion.PATIENTS AND METHODS: The study is conducted at Al-Elwiyah Maternity Teaching Hospital throughout the period between (April 2010 –July 2011). Ninety women participated in the study, they are at their early weeks of gestation (6-10) weeks. Their ages were between 18-40 years. thirty of them served as a control group (normal intrauterine pregnancy) and sixty pregnant women included in the study group and subcategorized into 2 groups. thirty women with suspected sub-acute or chronic cases of ectopic pregnancy according to ultrasound and β-HCG results and 30 women served as suspected missed abortion. blood samples were taken from the three groups followed by another blood samples after two-day interval to measure of serum progesterone levels. the results were compared among the three groups at first and second readings. p-value, standard deviation and 95% confidence interval calculated and statistically analyzed.RESULTS: P-value of the serial measurements of serum progesterone levels in two-day interval in the three groups was statistically insignificant. while serum progesterone levels of both ectopic pregnancy and missed abortion were greatly lower than serum progesterone levels of normal intrauterine pregnancy in both first and second readings, with statistically significant deference, P-value is CONCLUSION: Serum progesterone levels has a useful role in diagnosing ectopic pregnancy and missed abortion.


Article
The Success Rate of Expectant Management in The Treatment of 1st Trimester Missed Miscarriage

Author: Maysaloon Adnan Abd-Alrazzaq
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2455-2461
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: the expectant management has been considered possible alternative to surgical treatment (dilatation & curettage) of 1st trimester pregnancy missed miscarriage. Aim of study: to determine the successfulness & safety of 2 weeks expectant management for 1st trimester pregnancy missed miscarriage.Patients & methods: in this study was selected early pregnancy missed miscarriage, pregnant women ≤8weeks & pregnant women from 8-12 weeks.150 cases of missed miscarriage were collected but only 128 women agreed for expectant management after counseling. Which they are randomly selected managed expectantly over 7-14 days periods.Results: The results were found that the expectant management being successful in 65.6% (84/128) cases while being unsuccessful in 34.4% (44/128). 128 patients of this study attended follow-up to the karballa maternity hospital and were triaged by assessments of symptoms. 80 0f the patients ≤8 weeks the success rate was 100%,which is statistically highly significant =0.001 while 48 of patients 8-12 weeks success rate only 8.3% (4/48) while not success 91.7%(40/44)Discussion: Expectant management of 1st trimester missed miscarriage has been found now days to be a good alternative to other methods for treatment of missed miscarriage.It is safe, effective with good success rate which is 65.6% which is statistically highly significant. P=0.001Conclusion: Expectant management appears to be sufficiently successful, safe and effective to be offered as an option for women with 1st trimester missed miscarriage.

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