Oral misoprostol as first‐line care for incomplete abortion in Burkina Faso

Thiéba, Blandine; Ouattara, Adama Z.; Coral, Angela; Hassane, Cisse; Clotaire, Hien; Dao, Blami; Lankoandé, J.; Diop, Ayisha; Blum, Jennifer

doi:10.1016/j.ijgo.2012.05.036

Cited by 22 publications

(30 citation statements)

References 11 publications

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“…Misoprostol (600 mcg given orally or 400 mcg sublingually) has been shown to be an effective alternative to surgical treatment with similarly high rates of satisfaction [2-9]. The medication method can be offered by clinicians without surgical skills thus potentially increasing access for women while also reducing hospital costs and freeing up the time of over-burdened higher level providers [10,11]. …”

Section: Introductionmentioning

confidence: 99%

Results from a study using misoprostol for management of incomplete abortion in Vietnamese hospitals: implications for task shifting

Ngoc¹,

Shochet

Blum

et al. 2013

BMC Pregnancy Childbirth

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BackgroundComplications following spontaneous or induced abortion are a major cause of maternal morbidity. To manage these complications, post-abortion care (PAC) services should be readily available and easy to access. Standard PAC treatment includes surgical interventions that are highly effective but require surgical providers and medical centers that have the necessary space and equipment. Misoprostol has been shown to be an effective alternative to surgical evacuation and can be offered by lower level clinicians. This study sought to assess whether 400 mcg sublingual misoprostol could effectively evacuate the uterus after incomplete abortion and to confirm its applicability for use at lower level settings.MethodsAll women presenting with incomplete abortion at one of three hospitals in Vietnam were enrolled. Providers were not asked to record if the abortion was spontaneous or induced. It is likely that all were spontaneous given the legal status and easy access to abortion services in Vietnam. Participants were given 400 mcg sublingual misoprostol and instructed to hold the pills under their tongue for 30 minutes and then swallow any remaining fragments. They were then asked to return one week later to confirm their clinical status. Study clinicians were instructed to confirm a complete expulsion clinically. All women were asked to complete a questionnaire regarding satisfaction with the treatment.ResultsThree hundred and two women were enrolled between September 2009 and May 2010. Almost all participants (96.3%) had successful completions using a single dose of 400 mcg misoprostol. The majority of women (87.2%) found the side effects to be tolerable or easily tolerable. Most women (84.3%) were satisfied or very satisfied with the treatment they received; only one was dissatisfied (0.3%). Nine out of ten women would select this method again and recommend it to a friend (91.0% and 90.0%, respectively).ConclusionsThis study confirms that 400 mcg sublingual misoprostol effectively evacuates the uterus for most women experiencing incomplete abortion. The high levels of satisfaction and side effect tolerability also attest to the ease of use of this method. From these data and given the international consensus around the effectiveness of misoprostol for incomplete abortion care, it seems timely that use of the drug for this indication be widely expanded both throughout Vietnam and wherever access to abortion care is limited.Trial registrationClinicalTrials.gov, NCT00670761

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Section: Introductionmentioning

confidence: 99%

Results from a study using misoprostol for management of incomplete abortion in Vietnamese hospitals: implications for task shifting

Ngoc¹,

Shochet

Blum

et al. 2013

BMC Pregnancy Childbirth

Self Cite

View full text Add to dashboard Cite

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“…Health care workers are also experiencing challenges in PAC provision. Geese, Kabiru, Sidze, Muuo and Izugbara [12] conducted a study among Kenyan health care workers to assess the challenges they encounter in PAC provision. The study reveals different challenges such as non conducive working environment for PAC, stigmatization of health workers offering PAC by the public and other health workers, ambiguous abortion law, poor staffing, shortage of providers trained in PAC, and lack of essential PAC equipment (such as manual vacuum aspirators); medications, and supplies.…”

Section: Global Status Of Post Abortion Carementioning

confidence: 99%

“…[7] It was also confirmed by several studies that, the use of Misoprostol for uterine evacuation during PAC services is an effective and safest way. [12][13][14][15] Therefore it is safer to use vacuum aspiration (EVA) or manual vacuum aspiration (MVA) and Misoprostol to evacuate the uterus rather than using curettage and to provide appropriate PAC. These methods make it safer for PAC services to be rendered by the trained midwives or nurses even at the primary health care settings which make PAC services to be accessible in the community.…”

Section: Global Status Of Post Abortion Carementioning

confidence: 99%

Identified need for improving post abortion care in Namibia

Maano

Kerthu

2020

CNS

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Globally, about 75 million women have undergone abortions which is either induced or spontaneous and require post abortion care (PAC). Out of the 75 million abortions, 44 million are induced, while 31 million are miscarriages which occur spontaneously. Furthermore, half of the induced abortions are performed by unskilled people in a non-hygienic environment which make them unsafe and dangerous to the women.The World Health Organization recommends that all women who had abortion should receive PAC to prevent ill health and deaths related to complications of abortions. However, in Namibia, the status of PAC is unknown as there is no study conducted in this regard. Moreover, PAC is only conducted by medical doctors in the district hospitals and no nurses or midwives are trained on PAC services. A mini literature review was conducted on PAC globally and in Namibia.

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“…• Highly active antiretroviral therapy for preventing mother-tochild transmission of HIV [9,10] • Active management of the third stage of labor [12] • Bimanual compression [18] • Tamponade/compression sutures (e.g. B-Lynch) [19][20][21][22] • Safer cesarean (tranexamic acid) [40,41] • Magnesium sulfate (Magpie Trial) [37][38][39] • Manual vacuum aspiration [35,36] • Misoprostol [23][24][25][26][27][28][29][30][31][32][33][34] • Cervical cancer: visual inspection with acetic acid/see and treat/HPV capture/HPV vaccine • Breastfeeding (bleeding, neonatal, contraceptive benefits)…”

Section: Boxmentioning

confidence: 99%

“…• Family planning (postpartum, postabortion care, long-acting contraception, non-contraceptive benefits) [42] PPH in both primary and tertiary healthcare facilities, and with skilledbirth-assisted and home deliveries [23][24][25]. Misoprostol and manual vacuum aspiration (MVA), both individually and in combination, can be major contributors to reducing complications associated with incomplete abortion and improve access to care for women with requirements for all types of postabortion care [26][27][28][29][30][31][32][33][34][35][36]. Now that the science has demonstrated efficacy across multiple uses, many nongovernmental organizations and national/health entities are stepping up to implement access to these life-saving interventions through acquisition, supply chain distribution, and access/provision of services.…”

Section: Boxmentioning

confidence: 99%