Misoprostol substantially reduces serious complications in early termination of pregnancy

Cervical preparation with misoprostol reduces major complications of early surgical abortion by almost a third compared with placebo, according to new research published Online First in The Lancet.

Misoprostol is commonly used for cervical preparation prior to surgical abortion (vacuum aspiration) because it is effective, widely available, easy to use, and cheap. But until now, no studies have been large enough to assess whether misoprostol affects the occurrence of immediate or delayed (a few weeks after) serious complications from surgical abortion.

In this study, Eduardo Bergel from WHO, Geneva, Switzerland and colleagues compared rates of complications (cervical tear, uterine perforation, incomplete abortion, pelvic inflammatory disease, or any other serious event) of vacuum aspirations. 4972 women requesting a termination of (before 12 weeks gestation) from 14 centres in nine countries were randomly assigned to vaginal misoprostol (2485 women) or placebo (2487 women) 3 hours before aspiration.

Women given misoprostol were nearly a third less likely to experience one complication or more compared to those receiving placebo. Additionally, the risk of incomplete abortion was almost three times higher in the than in the misoprostol group. Minor cervical tears and uterine perforations were also less common in the misoprostol group.

, vaginal bleeding, and nausea were more frequent after treatment with misoprostol during the 3 hours prior to surgery. But no differences in the incidences of or other were noted between the groups.

The authors conclude: "Misoprostol reduced the overall incidence of complications, particularly incomplete abortions and unscheduled clinic visits and after abortion…Providers should be aware of the side-effects of the drug and inform women about these effects."

In an accompanying Comment, Allan Templeton from the University of Aberdeen in Scotland says: "The important issue…is the balance between effectiveness of the procedure and the side-effects of misoprostol, which will include abdominal cramps and vaginal bleeding in most women, although not to the extent of needing medical intervention before surgery."

In light of these new findings he adds: "Surely routine pharmaceutical dilation of the cervix should be recommended as an integral part of in all women."

add to favorites email to friend print save as pdf

Related Stories

Abortion drug's off-label use may have led to deaths

Jun 16, 2008

Preliminary U-M studies indicate that oral use of RU-486's companion drug misoprostol is safe, but vaginal use may undermine body's immune responses. The off-label use of a drug given with RU-486 to terminate a pregnancy ...

Abortion pill used in a quarter of US abortions

Jul 08, 2009

(AP) -- Roughly a fourth of American women getting early abortions last year did so with drugs rather than surgery, statistics show, as a new study reported improved safety in using the so-called "abortion pill."

No decline in US abortion rate

Jan 11, 2011

The number of abortions in the United States stayed at about the same level in 2008 as three years earlier, leveling off after a long period of decline, a survey said on Tuesday.

Recommended for you

Triglycerides significantly elevated in women with GDM

12 hours ago

(HealthDay)—For women with gestational diabetes mellitus (GDM), triglycerides are significantly elevated throughout pregnancy, according to a review published online Jan. 22 in BJOG: An International Jo ...

Safer childbirth for women everywhere

19 hours ago

Few women in developed countries die of blood loss in childbirth, but in remote areas and developing countries, an estimated 100,000 die every year from post-partum haemorrhage. 

10 tips to prepare for pregnancy

22 hours ago

For women of childbearing age looking to become pregnant, it is never too early to engage in healthy habits to ensure that she has a healthy pregnancy and her child has a healthy first step.

AAFP advocates for planned vaginal birth after cesarean

Jan 28, 2015

(HealthDay)—A planned labor and vaginal birth after cesarean (LAC/VBAC) is an appropriate option for most women with a history of prior cesarean birth, according to a clinical practice guideline published ...

Women diagnosed with PCOS twice as likely to be hospitalized

Jan 27, 2015

Women diagnosed with polycystic ovary syndrome - the most common hormone disorder in women of reproductive age - face a heightened risk of developing heart disease, diabetes, mental health conditions, reproductive disorders ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.