Oral misoprostol as first-line care for incomplete abortion in Burkina Faso

Objective: To explore 400-μg sublingual misoprostol as primary treatment in lower-level facilities with no previous experience providing postabortion care. Methods: Women presenting with incomplete abortion were offered a single dose of 400-μg sublingual misoprostol. Incomplete abortion was defined as uterine size consistent with fewer than 12 weeks of gestation, open cervical os, and reports of past or present history of vaginal bleeding. Women returned to the clinic 1 week after misoprostol administration for follow-up. At that time, they were discharged if the uterine evacuation was a success or were offered a second follow-up visit or surgical completion if still incomplete. Results: One-hundred women received misoprostol; outcome data were unavailable for 1 woman. Complete uterine evacuation was achieved for 97 (98.0%) women. Satisfaction was high, with nearly all women indicating that they were satisfied (n = 57 [57.6%]) or very satisfied (n = 41 [41.4%]) with their experience. Adverse effects were considered tolerable by 72 of 97 (74.2%) women. Ninety-seven of 99 (98.0%) participants indicated that they would choose misoprostol for incomplete abortion care in the future and 95 of 97 (97.9%) stated that they would recommend it to a friend. Conclusion: Misoprostol is a viable option for treatment of incomplete abortion at mid-level facilities. Clinical trials.gov: NCT00466999. © 2012 International Federation of Gynecology and Obstetrics.