DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174987

The use of misoprostol in outpatient treatment of abortions in the first quarter of pregnancy in Dakar

M. M. Niang, N. A. Fall Augowet, D. Diallo, M. Thiam, J. C. Moreau, C. T. Cisse

Abstract


Background: The objective of this study was to compare the effectiveness of misoprostol comparing to MVA in support of abortion from the first quarter.

Methods: This was a prospective, descriptive and analytical study (case-control study) made between January 1st and December 31st, 2015 in a level 1 maternity in Dakar.

Results: The study included316 first trimester abortions (158 were treated with misoprostol and 158 with MVA). The epidemiological profile was a woman aged on average 28.5 years and nulliparous (37%). The mean gestational age was 8 weeks 6 days. The rate of complete uterine evacuation was comparable in both groups (93% for misoprostol versus 94.3%for MVA) with a non-significant p-value. Side effects found (40.8%) were minor. The hospital stay averaged two hours in the misoprostol group against 24 hours for MVA. Anaemia was more common in the MVA group (44.1%) than in the misoprostol group (23.6%) (p = 0.0006). The cost of treatment with misoprostol (5620 CFA francs) was on average four times less than that of MVA (21,623 CFA francs).

Conclusions: Misoprostol can be seen as a credible alternative in the management of first quarter abortions because of its many advantages including its effectiveness, its easiness to be used in ambulatory, its low cost and safety.


Keywords


MVA, Miscarriages, Misoprostol

Full Text:

PDF

References


Weeks A. Expectative or surgical treatment in case of miscarriage. WHO Reproductive Health Library. Consulté le 15 Septembre 2014. Available at http://apps.who.Int/rhl/pregnancy_childbirth/antenatal_care/miscarriage/awcom1/fr/

Center for Training and Research in Reproductive Health (CEFOREP). Review of the literature on unsafe abortions in Senegal. Dakar Avril. 1998:70

Clark W, Shannon C, Winikoff B. Misoprostol for uterine evacuation in induced abortion and pregnancy failure. Expert Rev Obstet Gynecol. 2007;2(1):67-108.

American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 427: Misoprostol for postabortion care. Obstet Gynecol. 2009;113(2)(1):465-8.

Gueye M. Extension of post-abortion care in the regional hospitals of Kaolack and Diourbel and in the health center of Sokone. Thesis Med Dakar. 2006;63:27.

Faye KG. Interest of manual intrauterine aspiration in the management of pregnancies stopped at the gynecological and obstetric clinic of Dakar. Thesis Med Dakar. 2005;42:111.

Cissé CT, Faye KG, Moreau JC. First-trimester abortions in Chu de Dakar: Interest of manual aspiration intra-uterine. Med Trop. 2007;67:163-6.

Bugalho A, Mocumbi S, Faúndes A, David E. Termination of pregnancies of <6 weeks gestation with a single dose of 800 µg of vaginal misoprostol. Contracept. 2000;61:47-50.

Esteve CJ, Varela L, Velazco A, Tanda R, Cabezas E, Sánchez C. Early abortion with 800 µg of misoprostol by the vaginal route. Contracept. 1999;59; 219-225.

Jain JK, Dutton C, Harwood B, Meckstroth KR, Mishell DR. A prospective randomize, double-blinded, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Human Reprod. 2002;17(6):1477-82.

Paul B, Shelley C, Kurus. Provision of medical abortion: an introductory manual. Deuxième Edition Gynuity Health Projects (Deuxieme Edition), New York, NY 10010 USA; 2009.

Bagratee JS, Khullar V, Regan L, Moodley J, Kagoro H. A randomized controlled trial comparing medical and expectant management of first trimester miscarriage. Human Reprod. 2004;19(2):266-71.

Tang OS, Lau WN, Ng EH, Lee SW, Ho PC. A prospective randomized study to compare the use of repeated doses of vaginal and sublingual misoprostol in the management of first trimester silent miscarriages. Human Reprod. 2003;18:176-81.