To compare the safety, efficacy, and acceptability of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion in a hospital setting in Kampala, Uganda. Methods: Three hundred seventeen women ...To compare the safety, efficacy, and acceptability of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion in a hospital setting in Kampala, Uganda. Methods: Three hundred seventeen women with clinically diagnosed incomplete first-trimester abortions were randomized to treatment with either manual vacuum aspiration or 600 μ g misoprostol orally to complete their abortions. All women received antibiotics posttreatment and were followed up 1- 2 weeks later. Results: Regardless of treatment allocation, nearly all women in this study successfully completed their abortions with either oral misoprostol or manual vacuum aspiration (96.3% versus 91.5% , relative risk 1.05, 95% confidence interval 0.98- 1.14). Complications were less frequenl in those receiving misoprostol than those having manual vacuum aspiration (0.9% versus 9.8% , relative risk 0.1, 95% confidence interval 0.01- 0.78). In the 6 hours after treatment, women using misoprostol reported heavier bleeding but lower levels of pain than those treated with manual vacuum aspiration. Rates of acceptability were similarly high among women in the 2 treatment groups, with 94.2% and 94.7% of women reporling that their treatment was satisfactory or very satisfactory in the misoprostol and manual vacuum aspiration groups, respectively. Conclusion: For treatment of first-trimester uncomplicated incomplete abortion, both manual vacuum aspiration and 600 jug oral misoprostol are safe, effective, and acceptable treatments. Based on availability of each method and the wishes of individual women, either option may be presented to women for the treatent of incomplete abortion.展开更多
Objective: To determine the complications rate of termination of pregnancy (TOP) and the risk factors for complications following TOP. Methods: Retrospective observational study of the records of 1287 women who underw...Objective: To determine the complications rate of termination of pregnancy (TOP) and the risk factors for complications following TOP. Methods: Retrospective observational study of the records of 1287 women who underwent TOP in the Department of Obstetrics and Gynaecology of the Postgraduate Institute of Medical Education and Research, Chandigarh, India, between 1997 and 2001. First-trimester abortion was performed in 1088 women (85%) and second-trimester abortion in 199 women (15%). Most women (76%) were aged between 26 and 30 years; they were educated and requested TOP primarily to limit the number of their children or to space their births. A malformed fetus was the indication for TOP in 5.9%cases, and 16%of the women had medical disorders associated with the pregnancy. Suction evacuation was the method of choice for first-trimester abortion (88%); dinoprostone gel and extra-am-niotic saline solution plus oxytocin infusion were the primary methods (71%) for second-trimester abortion. Results: Uterine perforation occurred in 1 patient (0.09%) after a first-trimester abortion. The total rate of complications was 3.79%after firsttrimester and 4.0%after second-trimester abortions. Excessive hemorrhage and retained placenta were chief complications associated with second-trimester abortion. Incomplete abortion (1.5%) and minor infection were seen in 2.3%patients. The rate of complications was higher among parous women. Postabortion insertion of a CuT intrauterine device increased the need for a second course of antibiotics. Conclusion: Termination of pregnancy is safe if adequate care is taken while performing the procedure.展开更多
文摘To compare the safety, efficacy, and acceptability of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion in a hospital setting in Kampala, Uganda. Methods: Three hundred seventeen women with clinically diagnosed incomplete first-trimester abortions were randomized to treatment with either manual vacuum aspiration or 600 μ g misoprostol orally to complete their abortions. All women received antibiotics posttreatment and were followed up 1- 2 weeks later. Results: Regardless of treatment allocation, nearly all women in this study successfully completed their abortions with either oral misoprostol or manual vacuum aspiration (96.3% versus 91.5% , relative risk 1.05, 95% confidence interval 0.98- 1.14). Complications were less frequenl in those receiving misoprostol than those having manual vacuum aspiration (0.9% versus 9.8% , relative risk 0.1, 95% confidence interval 0.01- 0.78). In the 6 hours after treatment, women using misoprostol reported heavier bleeding but lower levels of pain than those treated with manual vacuum aspiration. Rates of acceptability were similarly high among women in the 2 treatment groups, with 94.2% and 94.7% of women reporling that their treatment was satisfactory or very satisfactory in the misoprostol and manual vacuum aspiration groups, respectively. Conclusion: For treatment of first-trimester uncomplicated incomplete abortion, both manual vacuum aspiration and 600 jug oral misoprostol are safe, effective, and acceptable treatments. Based on availability of each method and the wishes of individual women, either option may be presented to women for the treatent of incomplete abortion.
文摘Objective: To determine the complications rate of termination of pregnancy (TOP) and the risk factors for complications following TOP. Methods: Retrospective observational study of the records of 1287 women who underwent TOP in the Department of Obstetrics and Gynaecology of the Postgraduate Institute of Medical Education and Research, Chandigarh, India, between 1997 and 2001. First-trimester abortion was performed in 1088 women (85%) and second-trimester abortion in 199 women (15%). Most women (76%) were aged between 26 and 30 years; they were educated and requested TOP primarily to limit the number of their children or to space their births. A malformed fetus was the indication for TOP in 5.9%cases, and 16%of the women had medical disorders associated with the pregnancy. Suction evacuation was the method of choice for first-trimester abortion (88%); dinoprostone gel and extra-am-niotic saline solution plus oxytocin infusion were the primary methods (71%) for second-trimester abortion. Results: Uterine perforation occurred in 1 patient (0.09%) after a first-trimester abortion. The total rate of complications was 3.79%after firsttrimester and 4.0%after second-trimester abortions. Excessive hemorrhage and retained placenta were chief complications associated with second-trimester abortion. Incomplete abortion (1.5%) and minor infection were seen in 2.3%patients. The rate of complications was higher among parous women. Postabortion insertion of a CuT intrauterine device increased the need for a second course of antibiotics. Conclusion: Termination of pregnancy is safe if adequate care is taken while performing the procedure.
