Effectiveness of Misoprostol Versus Manual Vacuum Aspiration for the Treatment of the First Trimester Pregnancy Termination

Abstract

Objective: To compare the effectiveness of misoprostol versus manual vacuum aspiration (MVA) in the treatment of pregnancy termination at first 12 weeks of pregnancy, evaluating the outcomes among women undergoing these procedures.

Methodology: A comparative analysis was carried out at the Obstetrics and Gynaecology department of Bakhtawar Amin Hospital, Multan from January 2023 to December 2023, included pregnant women presented with age of gestation age up to 12 weeks, open cervical os and indication for elective termination of pregnancy. Participants were randomized into two groups. Misoprostol group received 400 mcg of misoprostol intravaginally every 4 hours for up to three doses for softening cervix, its dilatation, and uterine contractions, with starting oxytocin infusion after 6 hours. While manual vacuum aspiration group underwent the procedure under general anesthesia without receiving any uterotonics. Patients were followed up on the 7th day post-procedure, undergoing ultrasonography to measure endometrial thickness for efficacy assessment based on complete abortion.

Results: A total of 126 patients were comparatively studied; 63 in each group with mean age in the Misoprostol group was 33.45±3.11 years, and was slightly lower the MVA group as30.22±4.76 years. The average gestational age at the time of treatment was almost similar between the groups, 8.33 ±1.29 weeks for Misoprostol group and 7.99±2.56 weeks for the MVA group. The Misoprostol group exhibited an efficacy rate of 95.20% among patients, compared to 90.50% in the MVA group (P=0.148). Furthermore, the efficacy between Misoprostol and MVA across different age groups, gestational ages, and parity, was statistically insignificant (p->0.05).

Conclusion: Basis on the study findings, the efficacy of misoprostol for first trimester termination of pregnancy was observed to be 95.20%, slightly higher than the 90.50% with manual vacuum aspiration (MVA).