Journal of Rawalpindi Medical College (Sep 2017)
Comparison of Sublingual Misoprostol and Manual Vacuum Aspiration for the Treatment of Incomplete Abortion in First Trimester in Terms of Frequency of Decreased Haemoglobin Levels
Abstract
Background: To compare efficacy of manual vacuum aspiration with sublingual misoprostol for the treatment of incomplete abortion in terms of frequency of blood loss and decreased haemoglobin. Methods: In this randomized controlled trial, patients with incomplete abortion, open cervical os, vaginal bleeding, history of vaginal bleeding during this pregnancy and uterine size of less than or equal to 12wks menstrual period were included. Consenting women were randomized to either Group A who received a single dose of 600 microgram of sublingual misoprostol or Group B who underwent manual vacuum aspiration for evacuation of retained products of conception. Both groups comprised of 150 patients each. Pre and post (after 48 hours) treatment haemoglobin levels were measured. Results: Mean fall in haemoglobin level <1g/dl from baseline level was seen in misoprostol group while a mean fall of <0.5g/dl from baseline level was observed in MVA group (p<0.001, 95% CI, t=1.64, eta squared=0.006). A significant association was found with haemoglobin level, parity and age, with p=0.001, p= 0.05, p=0.02 respectively Conclusion: The efficacy of manual vacuum aspiration (MVA) is indicated by lower level of blood loss (Hb<0.5g/dl from baseline) as compared to 600μg sublingual misoprostol. MVA is associated with less complications than misoprostol.
