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Effect of misoprostol for cervical ripening prior to pregnancy interruption before twelve weeks of gestation
K A Okanlomo1, D Ngotho, J Moodley
1Department of Obstetrics and Gynaecology, University of Natal Medical School, Durban, South Africa.
Background:
Liberalization of the law in respect of legal abortions has led to a search for an appropriate technique for termination of pregnancy. The technique should be cheap, easy to perform and have minimal or no complications.
Aim:
To evaluate the effectiveness of performing manual vacuum aspiration (MVA) with and without the use of misoprostol to the procedure.
Design:
Randomised control study.
Setting:
Obstetrics and Gynaecology Department, University of Natal Medical School, South Africa.
Results:
One hundred and thirty six women were recruited; 70 women were assigned to the misoprostol group. Of these, 11 (15%) did not show any change in cervical score. Their mean cervical dilatation was similar to the control group (3.3 versus 31; p > 0.06). In the group whose gestational age was less than eight weeks, the time taken to complete the procedure, quantity of products of conception and cervical dilatation, were different from that of the control group, and this reached statistical significance except quantity of products of conception in primigravidae. In pregnancies greater than eight weeks gestation, all parameters assessed, such as cervical dilatation, quantity of products of conception was significantly different from the control group, in both multi- and primigravidae. Pain score was similar for all gestations.
Conclusion:
Misoprostol is of specific value during MVA for voluntary interruption of pregnancy.
