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Objectives: To conduct a drug-use evaluation by investigating indications, appropriateness of dosing, and clinical outcome of
misoprostol-only regimen when used for medical evacuation of spontaneous abortion.
Method: A retrospective descriptive drug-use evaluation was conducted on women with spontaneous abortion who received
misoprostol for medical evacuation during August 2013. The current practice at Women�s Hospital was compared with World Health
Organization (WHO) recommendation. Patients were stratified into three groups based on weeks of amenorrhea.
Results: One-hundred and seven patients received misoprostol during August 2013. Thirty-three patients (31%) were included. In
these patients, the main indication for using misoprostol was missed abortion (54.5%). In the group of �9 weeks, 80% of them received
an initial dose of 800 mcg, 80% received frequency within WHO recommendation, and most of them had surgical evacuation (80%).
In the group of 10 to 12 weeks, more than 80% received an initial dose of 800 mcg, 6% received frequency as WHO recommendation,
and more than 75% had successful medical evacuation. In the group of 13 to 22 weeks, more than 80% of them received an initial dose
of 400 mcg, more than 80% received frequency within WHO recommendation, and 54% of them had successful medical evacuation.
Overall, more than 70% of patients received �3 total doses of misoprostol and more than 60% had successful medical evacuation as
a clinical outcome.
Conclusions: Despite the current practice at Women�s Hospital not always in accordance with WHO recommendation, successful
medical evacuation was achieved in most patients.