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Misoprostol Cuts Complications in First-Trimester Abortion

Vaginal misoprostol before first-trimester vacuum aspiration reduces complications

THURSDAY, March 8 (HealthDay News) -- Vaginal administration of misoprostol before first-trimester abortion by vacuum aspiration is associated with reduced complications, according to a study published online March 8 in The Lancet.

Olav Meirik, M.D., from the World Health Organization in Geneva, and colleagues randomly assigned healthy women seeking first-trimester abortion to receive vaginal administration of misoprostol (2,427 women) or placebo (2,431 women) before vacuum aspiration. The women were followed for two weeks. Immediate and delayed complications of vacuum aspiration were recorded.

The researchers found that at least one complication was experienced by 2 percent of women in the misoprostol group and 3 percent of women in the placebo group (relative risk [RR], 0.68). In the misoprostol group, no women had cervical tears and three had uterine perforations, compared with two and one, respectively, in the placebo group. Incomplete abortions occurred in 19 women (<1 percent) in the misoprostol group versus 55 women (2 percent) in the placebo group (RR, 0.35), with uterine re-evacuation required by 14 women (<1 percent) in the misoprostol group and 48 women (2 percent) in the placebo group (RR, 0.29). There was no significant difference in the incidence of pelvic inflammatory disease or other serious adverse events between the groups.

"Cervical preparation with misoprostol before abortion by vacuum aspiration facilitates cervical dilation and reduces complications of the abortion, and should be considered together with the side-effects and with women's acceptance of the drug regimen," the authors write.

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