Medical Management of Miscarriage with Misoprostol

Indications and Contraindications

The American College of Obstetricians and Gynecologists indicates that misoprostol is used for missed abortion, which is the death of embryo or fetus without spontaneous expulsion, and incomplete abortion, which is the partial expulsion of products of conception with remaining tissue in the uterus, in the first trimester 1
Misoprostol should be avoided in patients with a previous cesarean delivery due to increased risk of uterine rupture, as recommended by the American Academy of Family Physicians 2

Side effects of misoprostol include gastrointestinal symptoms, fever/rigors, and pain, according to the American College of Obstetricians and Gynecologists 3

Medical management with misoprostol avoids anesthesia risks and surgical complications such as uterine perforation, cervical trauma, and Asherman syndrome, as noted by the American College of Obstetricians and Gynecologists 1