الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Misoprostol, the new synthetic analogue of PGE1 has radically changed the approach to first trimester missed abortion. where pregnancies clinically represented as missed abortions had been treated by surgical evacuation of the uterus. Although it considered quick and effective yet it remains invasive procedure and may be associated with certain risk as cervical trauma, uterine wall perforation and intrauterine adhesion. There are reports of use of sublingual misoprostol alone for abortion and of claims that it is better than vaginal misoprostol. Using of medical methods is excepted to cause gradual non traumatic dilation of the cervix, separation of the conceptus and expulsion of the conceptus. Few cases may need surgical evacuation to remove retained products of conceptus where it will become safe because of medical opening of the cervix and separation of the products of the conceptus.
Misoprostol is safe in both sublingual and vaginal route. The sublingual route is effective than vaginal route but the sublingual route has disadvantage of decrease the bioavailability and more gastrointestinal side effect.
The present study has been design to compare the safety and efficacy of the sublingual misoprostol versus the vaginal misoprostol for medical management of missed abortion.
The study is composed of 40 women, admitted to El- Shatby Maternity University Hospital, represented with a picture of first trimester missed abortion, the patients should be informed with the procedure, the medication, the benefits and possible complication, randomly allocated to take either 100µg (1\2 tablet of Misotac®) of sublingual Misoprostol or 100µg of vaginal Misoprostol, every four hours for maximum of four doses in either group and observe for 24 hours.
All cases were followed after Misoprostol administration should be follow up the blood pressure, pulse rate, side effects (e.g. nausea, diarrhea, vomiting, severe abdominal pain), body temperature, cervical dilatation, expulsion of the conceptus and follow up transvaginal ultrasound.