Treatment of an incomplete abortion that was treated surgically during the second trimester

  1. World Health Organization (WHO): Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. 2011, Geneva: WHO, 6

    Google Scholar 

  2. Weeks A, Alia G, Blum J, Winikoff B, Ekwaru P, Durocher J, Mirembe F: A randomized trial of misoprostol compared with manual vacuum aspiration for incomplete abortion. Obstet Gynecol. 2005, 106 (3): 540-547. 10.1097/01.AOG.0000173799.82687.dc.

    CAS  Article  PubMed  Google Scholar 

  3. Shwekerela B, Kalumuna R, Kipingili R, Mashaka N, Westheimer E, Clark W, Winikoff B: Misoprostol for treatment of incomplete abortion at the regional hospital level: Results from Tanzania. BJOG. 2007, 114 (11): 1363-1367. 10.1111/j.1471-0528.2007.01469.x.

    CAS  Article  PubMed  Google Scholar 

  4. Dao B, Blum J, Thieba B, Raghavan S, Ouedraego M, Lankoande J, Winikoff B: Is misoprostol a safe, effective and acceptable alternative to manual vacuum aspiration for post-abortion care? Results from a randomized trial in Burkina Faso, West Africa. BJOG. 2007, 114 (11): 1368-1375. 10.1111/j.1471-0528.2007.01468.x.

    CAS  Article  PubMed  Google Scholar 

  5. Bique C, Ustá M, Debora B, Chong E, Westheimer E, Winikoff B: Comparison of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion. Int J Gynaecol Obstet. 2007, 98 (3): 222-226. 10.1016/j.ijgo.2007.05.003.

    CAS  Article  PubMed  Google Scholar 

  6. Blum J, Winikoff B, Gemzell-Danielsson K, Ho PC, Schiavon R, Weeks A: Treatment of incomplete abortion and miscarriage with misoprostol. Int J Gynaecol Obstet. 2007, 99 (Suppl 2): S186-S189.

    CAS  Article  PubMed  Google Scholar 

  7. Diop A, Raghavan S, Rakotovao JP, Comendant R, Blumenthal PD, Winikoff B: Two routes of administration for misoprostol in the treatment of incomplete abortion: a randomized clinical trial. Contraception. 2009, 79 (6): 456-462. 10.1016/j.contraception.2008.11.016.

    CAS  Article  PubMed  Google Scholar 

  8. Dabash R, Ramadan MC, Darwish E, Hassanein N, Blum J, Winikof B: A randomizes controlled trial of 400-μg sublingual misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion in two Egyptian hospitals. Int J Gynaecol Obstet. 2010, 111 (2): 131-135. 10.1016/j.ijgo.2010.06.021.

    CAS  Article  PubMed  Google Scholar 

  9. Taylor J, Diop A, Blum J, Dolo O, Winikoff B: Oral misoprostol as an alternative to surgical management for incomplete abortion in Ghana. Int J Gynaecol Obstet. 2011, 112 (1): 40-44. 10.1016/j.ijgo.2010.08.022.

    CAS  Article  PubMed  Google Scholar 

  10. Akin A, Blum J, Ozalp S, Onderoğlu L, Kirca U, Bilgili N, Koçoğlu G, Philip N, Winikoff B: Results and lessons learned from a small medical abortion clinical study in Turkey. Contraception. 2004, 70 (5): 401-406. 10.1016/j.contraception.2004.05.005.

    Article  PubMed  Google Scholar 

  11. Akin A, Dabash R, Dilbaz B, Aktün H, Dursun P, Kiran S, Aksan G, Doğan B, Winikoff B: Increasing women’s choices in medical abortion: a study of misoprostol 400 microg swallowed immediately or held sublingually. Eur J Contracept Reprod Health Care. 2009, 14 (3): 169-175. 10.1080/13625180902916020.

    CAS  Article  PubMed  Google Scholar 

  12. Grossman D, Ellertson C, Grimes DA, Walker D: Routine follow-up visits after first-trimester induced abortion. Obstet Gynecol. 2004, 103 (4): 738-745. 10.1097/01.AOG.0000115511.14004.19.

    Article  PubMed  Google Scholar 

  13. Fjerstad M: Figuring out follow-up. Mifematters PPFA/CAPS. 2006, 13: 2-3.

    Google Scholar 

  14. American College of Obstetricians and Gynecologists: Misoprostol for postabortion care. ACOG Committee Opinion No. 427. Obstet Gynecol. 2009, 113: 465-468.

    Article  Google Scholar 

  15. World Health Organization: Safe abortion: Technical and policy guidance for health systems. 2012, Geneva: WHO, 2

    Google Scholar 

  16. World Health Organization (WHO): WHO model list of essential medicines. 2010, Geneva: WHO, 16

    Google Scholar 

  • The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2393/12/127/prepub


Page 2

  Group 1: Misoprostol Group 2: Surgical p-value
  n = 480 n = 380  
Age in years: mean ± SD (range) 28.1 ± 7.2 (13-48)a 28.7 ± 7.3 (14-46)b 0.19
Education level: % (n)    0.63
 No education 30.6 (118/385) 28.3 (80/283)
 Primary 24.9 (96/385) 23.7 (67/283)
 Secondary 30.9 (119/385) 31.1 (88/283)
 Tertiary 13.5 (52/385) 17.0 (48/283)
Marital status: % (n)    0.20
 Single 11.5 (55/478) 8.3 (31/372)
 Married 87.0 (416/478) 90.9 (338/372)
 Divorced 1.5 (7/478) 0.8 (3/372)
Parity: mean ± SD (range) 2.1 ± 2.1 (0-11)c 2.3 ± 2.2 (0-11)d 0.09
Abortion type according to provider: % (n)    0.23
 Spontaneous 94.0 (440/468) 95.9 (349/364)
 Induced 6.0 (28/468) 4.1 (15/364)  

  1. * Denominators vary due to response rate for each question.
  2. a n = 478.
  3. b n = 375.
  4. c n = 479.
  5. d n = 377.