Comparison of Manual Vacuum Aspiration and Misoprostol in the Management of Incomplete Abortion

Background: Incomplete abortions can be managed expectantly; surgically and medically (using misoprostol). Expectant management is safe in places where women have access to information; appropriate care and follow-up; however; in isolated and poor areas women who come for help need an intervention.Objective: To compare the efficiency of manual vacuum aspiration (MVA) and misoprostol in the treatment of incomplete abortion.Patients and method: This was a prospective study over five months from March to August 2015. All patients admitted with a diagnosis of incomplete abortion were recruited into the study.Results: 308 patients with incomplete abortion were randomized into two treatment groups - MVA (done under local anaesthesia) and misoprostol (400 micrograms by the vaginal route). MVA was successfully performed for all patients. Two patients presented with anaemia. In the misoprostol group; 23 patients had vaginal bleeding; and 10 persistence of incomplete abortion. Conclusion: MVA is more effective than misoprostol with less complications in the treatment of incomplete abortion when it is done by a trained person

Treatment of first trimester abortion with human chorionic gonadotropin

The results of human chronic gonadotrophin administration were studied in 281 pregnant women. The patients were divided into two groups i,e the study was two parts, group A, 97 cases of threatened abortion during first trimester of pregnancy, with or without history of previous abortion. Group B, 184 cases with intact gestation, gave history of previous abortion during first trimester or corpus luteum insufficiency was suspected clinically. In both groups the drug was administered intramuscularly in an initial dose of 10000 I.U. followed by 5000 I.U. each third day and continued till the end of the twelfth week of gestation. In-group A. this sort of therapy was administered after ensuring viability by ultrasound examination. In group B, the treatment was started as soon as the pregnancy was diagnosed by ultrasound examination. In group A 20.6% aborted, and abortion recurred in 75% of habitual aborters, while 3.8% group B aborted and 4.62% of habitual aborters aborted in spite of treatment. 14.94% of cases were lost after sixteen weeks of gestation and during second trimester and 24.55% of cases were lost during third trimester. Incidence of congenital anomalies among 143 cases who could be followed till delivery delivery was 2.09%. None showed any sign of allergic reactions during the course of therapy. The cesarean section rate and sex ratio were also determined. It is concluded that Human Chorionic Gonadotrophin is an imert and effective drug in preventing abortion when compared with results of previous studies on progesterone therapy or results of being left without treatment, provided that its use is planned prior to pregnancy and started prior to occurrence of bleeding