Vaginal misoprostol alone is effective in the treatment of missed abortion.

Introduction bortion or miscarriage is the spontaneous end of pregnancy at a stage when the embryo or fetus is incapable of surviving independently, generally defined in humans of prior to 20 weeks of gestation. More than 50% of human pregnancies may be lost although in only in 15% in this perceived as miscarriage. The incidence of this type of abortion is very high during first trimester and decreases with increasing gestational age. Of many type of abortion, missed abortion occurs when the embryo or fetus has died but miscarriage has not yet occurred. The retention of fetus known to be dead for >4 weeks. The cervix is closed and there is no or only slight bleeding. Ultrasound examination shows an empty gestational sac or an embryo/ fetus without cardiac activity. The standard treatment of both spontaneous and missed abortion used to be surgical evacuation of uterus but expectant management or medical treatment are becoming reasonable alternatives.. Medical treatment commonly consists of administration of a progesterone antagonist (mifepristone) followed by some form of prostaglandin (misoprostole) to induce uterine contraction and expulsion of product of conception. The administration of mifepristone is invariably oral but different prostaglandins may be given in different waysparentral, oral or local (intra-vaginal). Studies have demonstrated that the vaginal administration of misoprostol may be more effective than oral route. In cases of missed abortion the administration of mifepristone may be superfluous, as progesterone levels are in the range of luteal phase (i.e lower