Role of Medical Treatment in Abortion-An Observational Study

Abstract

Background: Medical treatment of abortion has been identified as safe and effective Method of evacuation of uterus and is more amenable to provision through primary care facilities, ever where providers may not have the skills to perform a surgical evacuation. Medical treatment of abortion care encompasses the management of various clinical conditions including incomplete abortion missed abortion, blighted ovum, as well as post-abortion contraception. Medical management of abortion generally involves misoprostol. Objective: To assess the role of medical treatment in abortion in pregnant women-an observational study. Methods: This is an observational study done at Uttara Adhunik Medical College Hospital, Dhaka, Bangladesh from July 2021 to July 2023. 101 patients fulfilling the inclusion criteria were enrolled. This is an attempt to study incomplete abortion after medical treatment of abortion and to observe the success read of this method of taking it among patients, with prescriptions or without it. Questionnaires were prepared and women were interviewed. Questions pertaining to women knowledge, attitude, perception and use of medicine for treatment of abortion, use of emergency contraception were asked. Study was carried out by using responses in the preform given. Results: This study was done in duration of two years and 101 patients fulfilling the inclusion criteria were enrolled. Women who had ectopic pregnancy, threatened abortion & excessive P/V bleeding were excluded. In our study, most of the women interviewed, were between 25-34 years of age (51.5%). Out of the 101 women, 99 women (98.01%) were married and 2 (1.99%) were unmarried. 76 women (75.2%) belonged to urban residence. 16 women (15.9%) were working women. 81 women (80.2%) were housewives. 4 (3.9%) interviewed were students. 41 women interviewed were illiterate (40.6%) while only 9 women (8.9%) were graduates. In our study, majority of women 76 (75.2%) had taken abortifacient or spontaneous abortion occur at <12 weeks of gestation. However, 05 (4.9%) women did not know about their gestational age. Main complication after taking medicine for abortion was moderate bleeding mentioned by 60 women (59.4%), incomplete abortion by 10 women (9.90%), Repeat prescription after 1 week 05 women (4.95%), pain by 27 women (26.7%) and need MVA or D&C by 07 women (6.93%). Among the 101 women who used misoprostol with known outcome, 90.09% had complete abortions, 10 (9.90%) had incomplete abortions. The rates of incomplete abortion and surgical intervention were not significantly different among the women with administration of misoprostol. Among blighted ovum after treatment, complete abortion 69.3% and 30.7% incomplete abortion. Conclusion: Medical treatment of abortion is safe and effective but complications can occur if not used in accordance. However, the awareness about medical treatment of abortion is increasing. It is therefore of utmost importance to increase the awareness about medical treatment of abortion not only among doctors but also among general population.