Abstract
Author(s): Magdalena Markiewicz-Zahorski*, Magdalena Bednarczyk, Katarzyna Barabasz, Olga Kacalska-Janssen, Robert Jach and Magdalena Piróg
Objectives: To evaluate clinical and demographic factors influencing the effectiveness of misoprostol pharmacotherapy in women diagnosed with spontaneous abortion.
Materials and Methods: This retrospective study included 120 women aged 23–41 years diagnosed with spontaneous abortion and treated at the University Hospital in Krakow from January 2023 to February 2025. Exclusion criteria were contraindications to misoprostol, preference for surgical treatment, and ectopic or unknown-location pregnancies. Diagnosis was confirmed by transvaginal ultrasound or by declining serum beta-human chorionic gonadotropin (β-hCG) levels without fetal cardiac activity. Misoprostol was administered following a standardized protocol, with ultrasound monitoring before each dose. The number of doses and treatment-related symptoms were recorded. Statistical analysis included the Mann–Whitney U, chi-square or Fisher’s exact tests, and logistic regression to identify predictors of treatment failure. A p-value ≤ 0.05 was considered statistically significant.
Results: Of 120 women, 58 (48%) were successfully treated with misoprostol alone, while 62 (52%) required surgical curettage. No significant differences in age, body mass index (BMI), or obstetric history were observed between groups. Successful treatment was associated with lower gestational age (–10.6%). Adverse events such as diarrhea and mild abdominal pain occurred similarly in both groups; no hemorrhages were reported in the misoprostol-only group.
Conclusions: Gestational age is the primary predictor of successful pharmacological management of miscarriage with misoprostol. The treatment is safe and effective, supporting its use as first-line therapy in selected patients.