Factors Associated with Management Outcome of Incomplete Abortion in Yirgalem General Hospital, Sidama Zone, Southern Ethiopia

Misoprostol versus expectant management in women with incomplete first-trimester miscarriage after failed primary misoprostol treatment: A randomized clinical trial

OBJECTIVE

To compare the effectiveness and safety of repeat misoprostol versus expectant management in women with first-trimester incomplete miscarriage who have been initially treated with misoprostol.

METHODS

The study was an open-labeled randomized controlled trial including women with an incomplete first-trimester miscarriage after administration of misoprostol. The participants were randomly assigned to vaginal misoprostol or expectant management using a computer-generated table of random numbers. The primary outcome was the number of women with a complete miscarriage at 1 week.

RESULTS

Eighty-eight women (44 women in each group) were analyzed. The rate of complete miscarriage at 1 week was significantly higher in the misoprostol group than the expectant management group-29 (69.0%) versus 7 (16.7%) (P < 0.001), respectively. Women in the misoprostol group were more satisfied (7.00 ± 0.77 vs 4.57 ± 1.61, P < 0.001) but reported more pain (7.95 ± 1.85 vs 5.26 ± 1.08, P < 0.001) than women in the expectant group. The misoprostol group reported more adverse effects than the expectant management group (P < 0.001).

CONCLUSION

In women with an incomplete first-trimester miscarriage who were initially treated with misoprostol, repeat administration of misoprostol was more effective than expectant management for achieving complete miscarriage at 1 week. However, misoprostol was associated with more adverse effects.

REGISTRATION SITE AND NUMBER

Clinicaltrials.gov: NCT03148561.

The Economic Burden of Abortion and Its Complication Treatment Cares: A Systematic Review

Objective: Abortion related procedures contribute to a significant economic burden because it resulted in prolonged hospital stays for patients. We aimed to gather available evidence on the economic burden of abortion and post-abortion complication treatment cares worldwide.

Materials and methods: PubMed, Web of Science, Scopus, and Embase databases were searched through November 2019. Two researchers independently conducted the quality assessment and data extraction process. The latest web-based tool adjusted the estimates of costs expressed in one specific currency and price year into a specific target currency (the year 2016 $US).

Results: Totally, 2082 records were retrieved and 32 studies were deemed eligible for qualitative synthesis. The mean total costs per patient with abortion or post-abortion care ranged from $23 to $564. The annual costs ranged from 189,000 $US to 134 million $US.

Conclusion: Abortion and post-abortion care impose a substantial economic burden on society. Understanding the burdensome of abortion or pregnancy termination among policymakers provides vital information and enables informed decisions to be made to establish health care priorities and allocating scarce resources.