Medical management of early pregnancy failure in a patient with coronary artery disease.

Abstract:

OBJECTIVE:To describe a case of early pregnancy failure in a patient who was not an optimal candidate for suction aspiration because of her body habitus and history of a myocardial infarction that was treated medically with misoprostol. DESIGN:Case report. SETTING:Academic tertiary-care hospital. PATIENT:A 43-year-old woman with morbid obesity, coronary artery disease, previous myocardial infarction, obstructive sleep apnea, and other medical problems who presented with an early pregnancy failure. INTERVENTION:Medical management with 800 microg of vaginal misoprostol in an inpatient setting with cardiac monitoring. MAIN OUTCOME MEASURE(S):Ultrasonographic resolution of intrauterine pregnancy, vaginal bleeding, and cardiac events. RESULT(S):No gestational sac was visualized by ultrasound on the second hospital day, the patient's hemoglobin value at discharge was 12.1 mg/dL, and no adverse cardiac events occurred. CONCLUSION(S):Medical management with misoprostol on an inpatient basis is a possible alternative to dilation and curettage in patients with complex medical problems and early pregnancy failure.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Hackney DN,Creinin MD,Simhan H

doi

10.1016/j.fertnstert.2006.11.010

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

212.e1-3

issue

1

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(06)04446-3

journal_volume

88

pub_type

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