Estradiol Pretreatment With Misoprostol in Second Trimester Miscarriage

Estradiol Pretreatment With Misoprostol in Second Trimester Miscarriage: A Prospective, Double-blind, Randomized Clinical Trial

To compare the effectiveness of estradiol pretreatment with misoprostol and vaginal misoprostol alone in induction of second trimestr miscarriage.

Inclusion Criteria:

• Maternal age more than 18 years old (age of legal consent).
• Gestational age between 12-26 weeks.
• Hb level > 10 g/dL.
• BMI between 25 kg/m2 and 35 kg/m2.
• Missed abortion.
• Living fetus with multiple congenital malformations incompatible with life.
• PPROMS with drained liquor and parents are consenting for termination of pregnancy.

Exclusion Criteria:

• Maternal age less than 18 years old.
• Gestational age less than 12 weeks or more than 26 weeks.
• Hb level < 10 g/dL.
• Scared uterus (previous myomectomy - cesarean section - hysterectomy and ruptured uterus).
• Polyhydramnios.
• Anencephaly.
• Fibroid uterus.
• BMI less than 25 kg/m2 and more than 35 kg/m2.
• Coagulopathy.
• Previous attempts for induction of abortion in the current pregnancy.
• Allergy to misoprostol or estradiol.
• Placenta previa.
• Medical disorder that contraindicate induction of abortion (e.g. heart failure).