Comparison of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion

Objective: To compare the safety, efficacy, and acceptability of misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion in Maputo, Mozambique. Methods: A total of 270 women with clinically diagnosed incomplete abortions of up to 12 weeks of gestation were randomized to either 600 μg oral misoprostol or MVA. Women were followed-up seven days later to evaluate whether the abortion was complete. Results: Success was high for both MVA and misoprostol groups (100% vs 91%, P = 0.002). Women in the MVA arm reported fewer side effects but higher pain scores. Women who received misoprostol were significantly more likely to be "very satisfied" with the treatment and willing to choose the method again. Conclusion: Although oral misoprostol was less effective than MVA in this study, it was more acceptable to women. Misoprostol is well-suited for use in low-resource settings, and should be promoted as an option for the treatment of incomplete abortion. © 2007 International Federation of Gynecology and Obstetrics.