Comparative Study Between Combined Vaginal Misoprostol

Comparative Study Between Combined Vaginal Misoprostol With Isosorbide-5-Mononitrate Versus Misoprostol Alone For Induction Of The First Trimester Missed Abortion A Randomized Clinical Trial

"Comparative study between Combined Vaginal Misoprostol with Isosorbide-5-Mononitrate

"Comparative study between Combined Vaginal Misoprostol with Isosorbide-5-Mononitrate versus Misoprostol Alone For Induction Of The first trimester Missed Abortion A Randomized Clinical Trial"

Inclusion Criteria:

• - Maternal Age 18 - 35 years.
• Gestational age first trimester of pregnancy (between 5-13 weeks).
• Missed abortion confirmed by ultrasound.
• Singleton pregnancy.
• Normal uterus and cervix on clinical examination.
• Cervix is not dilated.
• No vaginal bleeding.

Exclusion Criteria:- Evidences suggesting start of spontaneous abortion and previous trial to induce abortion.

• Presence of uterine contraction or bleeding,
• Multi-fetal pregnancy.
• Suspicion of septic abortion.
• History of Previous cervical surgery or manipulation. Ex: cervical tear , cervical cauterization .
• Uterine anomaly.
• Presence of IUD( intrauterine device) in situ
• Underlying medical diseases.Ex:diabetes mellitus,hypertension
• History of allergy or adverse effects to vaginally administered medication e.g. isosorbide -5- mononitrate
• Those unwilling to participate in the trial
• Higher order cesarean section(more than three