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Estudio clínico aleatorizado de la eficacia del metrotexato mas misoprostol en el manejo clínico del aborto. Hospital José Carrasco Arteaga

Abstract:

Background: The World Health Organization informs that in developed countries between 25% and 50% percent of maternal death are caused by abortion. In our country the most applied treatment is the Endouterine Manual Aspiration followed by Uterine Instrumental Curettementl. Although clinical treatment of abortion has had satisfactory responses worldwide, it has been poorly applied and investigated in our country. Aims: To evaluate the efficacy of combined therapy of misoprostol plus methotrexate compared to misoprostol alone during clinical management of abortion. Method and Techniques: a double-blind randomized clinical trial was conducted at the Hospital José Carrasco Arteaga, a group of 126 patients with abortion up to 12 weeks of gestation, divided into 63 patients. In the first group or groups, methotrexate is prescribed 50 mg orally, and then via vaginal misoprostol 800 microgram every 12 hours for two doses. In the second group 800 microgram vaginal misoprostol every 12 hours for two doses prescribed. A transvaginal ultrasound at 24 hours was performed to check for uterine evacuation Results:.Complete uterine evacuation occurred in 68.2% for the experimental group and 52.4% for the control group, AMEU was performed in six patients (9.5%) for the experimental group and eleven patients (19.1%) for the control group and LUI was performed in fourteen patients (22.2%) for the experimental group and nineteen patients (30.1%) for the control group, not a complete uterine evacuation with clinical therapy. For the most common side effects observed are pelvic pain 31.7%, increased vaginal bleeding 26.2% and nausea11.1%.