A Randomized Trial of Misoprostol Compared With Manual Vacuum Aspiration for Incomplete Abortion

Abstract

I.

The medical management of missed miscarriage: outcomes from a prospective, single‐centre, Australian cohort

“…This dose has successfully evacuated the uterus in over 1000 women in over a half a dozen trials worldwide. 9,10,19,20,11 Recently completed trials testing 400 mcg sublingual misoprostol compared to 600 mcg oral misoprostol found that that the 400 micrograms sublingual dose is as effective as 600 micrograms oral misoprostol when used for treatment of incomplete abortion. 22 Although the data in support of the 400 microgram sublingual misoprostol dose are less extensive, it may be shown in the future to be the optimal dose and route of administration for this indication.…”

“…5,9,10,12,14,19,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38]41 (Table 1) The success rate reported in trials is closely related to the length of time after treatment at which the uterus is reassessed by ultrasound exam. 16 Early studies on the use misoprostol for incomplete abortion tested a range of doses (400 mcg to 1200 mcg) and routes (oral, vaginal, intrauterine, etc.…”

“…In these trials, a 600 mcg oral dose was tested in more than 1000 women. 9,10,19,20 In most cases, complete uterine evacuation was ascertained using clinical criteria alone. Only one of four published studies (in Burkina Faso) testing this regimen required that women have their abortion status validated by ultrasound.…”

“…In five randomized controlled trials (n=1484) women reported significantly more "heavy" (more than a period) and "normal" (same as a period) bleeding with misoprostol than following MVA. 9,10,19,20,41 Women in both arms reported similar amounts of "light bleeding" (less than a period) or "spotting" following either MVA or misoprostol treatment.…”

Abortion in Turkey: women in rural areas and the law

“…The advent of vacuum aspiration in the 1960s revolutionised the The vacuum aspiration method is also a safe, effective, and acceptable treatment for the treatment of first-trimester uncomplicated incomplete abortion, as is 600 µg oral misoprostol. [22][23][24] MVA is faster, safer, more comfortable, and associated with shorter hospital stay for induced abortion than sharp curettage. 25,26 Additional advantages compared with sharp curettage are its ease of use as an outpatient procedure, the need for less analgesia and anaesthesia, 27 and its lower cost per procedure, especially if done on an outpatient basis.…”