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Review. Misoprostol vs Manual Vacuum Aspiration For Incomplete Abortion In Low Resource Settings.

A Review of the Use of Misoprostol Compared with Manual Vacuum Aspiration For Incomplete Abortion In Low Resource Settings. By Ellen McAuley

Full article:LIME-Misoprostol Review

Abstract

Objective: To conduct a literature review of studies comparing the safety, efficacy and viability of the drug misoprostol in comparison with manual vacuum aspiration for the treatment of incomplete abortion in low resourced settings.

Methods: A literature review was the selected method used to compare the treatment options for incomplete abortion. An online search was conducted using databases including “Scopus”, “Medline” and “Discover”. Keywords were chosen to refine the search and studies published after 2005 were selected and reviewed.

Results: Both misoprostol and manual vacuum aspiration appear to be highly effective although misoprostol appears to be the more cost effective of the two. Successful outcomes ranged from between 91-99% in misoprostol groups and between 99-100% in those treated with MVA (3-9). Ratings of “satisfactory/very satisfactory” are also high in both options, ranging from 94.7-108% and 94.2-103% for MVA and misoprostol respectively (2,3,4,5,7,8). Use of diagnostic sonography before and after treatment was varied in all the studies reviewed, a table reporting its use  can be found in the appendix of this review. In terms of side effects pain/cramps and bleeding were the most frequent. Misoprostol was deemed to induce more tolerable side effects, with “tolerable/ easily tolerable” provided as an answer in 77-95.5% of patients(3-8).  Complications involved in both procedures were infrequent.

Conclusion: For treatment of first trimester incomplete abortion misoprostol appears to be a safe, effective alternative to manual vacuum aspiration. In low resource settings its low costs, and potential to aid in the decentralization of healthcare by its simplicity of administration especially in low level healthcare facilities could prove vital as first line treatment for incomplete abortion a common occurrence and health threat for the women of developing nations.

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