الفهرس 
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Abstract
The purpose of this thesis was to evaluate the efficacy and safety of misoprostol ”PGE1, analogue” when given sublingually for missed abortions in the first trimester.
This study was conducted during the period from March 2009 till March 2010, on 30 women with ultrasound proven first trimester missed abortion.
Every woman in the study took misoprostol (cytotec®) 400g sublingual every three hours, up to a maximum five doses over 24 hours. The same doses were repeated for another 24 hours in non-responders. Patients subsequently were seen 24 and 48 hours after the initial dosing
Misoprostol Sublingual was re-administered in the second day, only if ultrasound images revealed evidence of persistent pregnancy tissue. By 48 hours after initial study entry, if either a gestational sac or placental tissue was present, this was considered a failure, and uterine curettage was done.
We found that administration of misoprostol sublingually is effective for 1st trimester missed abortions as regards:
1- Percentage of women succeeded to be aborted was 90% (27 from30) 21(77.7%) of them aborted within the first 24 hours and 6 (22.3 %) of them aborted within the second 24 hours.
2- Percentage of retained placenta after 48 hours of sublingual misoprostol therapy was 3 (10%).
3- Median induction to abortion intervals was 14.5 hours.
4- The incidence of lower abdominal pain after initiation of sublingual misoprostol therapy was 93% ”28 from 30” but analgesics were needed only in 40% of patients”12 from 30”.
5- The incidence of diarrhea was 56% ”17 from 30”.
6- The incidence of vomiting was 20% ”6 from 30”.
7- The incidence of increased vaginal bleeding after initiation of sublingual misoprostol therapy was 10% ”3 from 30”.