An observational study to evaluate fall in hemoglobin following abortions conducted by misoprostol and surgical methods

Subrata Das, Swapnil Wilson, Somila Xess


Background: Over the past three decades, medical methods of abortion have been developed throughout the world and are now the standard methods of providing abortion care in addition to surgical methods. There are various differences between the two methods. In this study, evaluating the fall in haemoglobin levels in abortions conducted by misoprostol and D and E in women with pregnancy failure.

Methods: Total of 80 women who fulfilled the criteria were included in the study. Inclusion and exclusion criteria applied and Hb levels noted on day 1 and 15 during follow up. In addition to this induction abortion interval and side effects of both the methods were also studied. Participants assigned to medical treatment received 800 μg of misoprostol inserted into posterior vaginal fornix i.e., day 1st and repeat dose on day 3 if no expulsion. Follow up done after 1 week and 15 days, if there was no expulsion, suction and evacuation was done. Participants assigned to dilatation and evacuation group would undergo the procedure in operation theatre. Statistical analysis done.

Results: The mean induction to abortion interval in the misoprostol group was 9.1±2.1 hours (mean±SD). The mean hemoglobin level in the misoprostol group on day 15 was 9.7±1.12 and that in the D and E group was 10.26±1.31 p value (0.04), statistically significant.

Conclusions: Proper counseling of the side effects in both the methods and prompt action to alarming signs are required to avoid major disaster.


Abortion, D and E, Misoprostol

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Pazol K, Creanga AA, Zane SB, Burley KD, Jamieson DJ. Abortion surveillance-United States 2009. Centers for Disease Control and Prevention (CDC). MMWR Surveill Summ. 2012;61(SS-8):1-44(Level II-3).

Prema K, Ramalakshmi BA. Effect of medical termination of pregnancy on haemoglobin status. Indian J Med Res. 1979;69:605-8.

Thonneau P, Poirel H, Fougeyrollas B, Maria B, Meyer L, Goepp A, et al. A comparative analysis of fall in haemoglobin following abortions conducted by mifepristone (600 mg) and vacuum aspiration. Hum. 1995;10(6):1512-5.

Davis AR, Hendlish SK, Westhoff C. Bleeding patterns after misoprostol versus surgical treatment of early pregnancy failure, results from an RCT. Am J Obstet Gynecol. 2007;196:31.e1-31.e7.

Thomas B, Habeebullah S. Vaginalmisorostol for medical evacuation of early pregnancy failure. JGOG India, 2004;54(4):340-2.

Singh K, Fong YF, Dong F. A viable alternative to surgical vacuum aspiration: repeated doses of Intravaginal misoprostol over 9 hours for medical treatment of pregnancies up to 8 weeks. BJOG. 2003;10:175-80.

Shuaib AA. Alharazi AH. Medical versus surgical termination of the first trimester missed miscarriage. Alex J Med. 2013;49(1):13-6.

Shokry M, Fathalla M, Hussien M, Eissa AA. Vaginal misoprostol versus vaginal surgical evacuation of first trimester incomplete abortion: comparative study. Middle East Fertil Soc. 2014;19:96-101.