Adeela Tahir, Farzana Aamir.
To compare the efficacy of manual vacuum aspiration verses misoprostol in first trimester incomplete miscarriage.
Pak J Surg Jan ;34(3):250-4.

Objective: To compare the efficacy of manual vacuum aspiration verses misoprostol in first trimester incomplete miscarriage Material and Methods: All patients with first trimester miscarriage assessed by ultrasound, On bimanual pelvic examination uterine size less than or equal to 12 weeks size with open cervix , maternal age between 18-35 years, parity less than or equal to 4 and gravidity less than or equal to 5 were included in this study. Consenting women randomized to either description of the method picked by the lottery method. All participants regardless of treatment assigned given tablet Brufen 400mg and vibramycin 100mg for pain relief and infection prophylaxis. The patients are offered follow up visit after 1 week with an ultrasound report. The final outcome was measured after one week of the procedure. Results: Mean age of the patients in MVA group was 28.2±5.68 years whereas in misoprostol group was 26.56±5.43 years. In MVA group, In contrast mean gestational age in MVA group was significantly lower 66.54±11.02 days whereas in misoprostol group was 65.75±10.93 days, gestational age of most of the patients in both groups was found < 70 days. Pain score-wise comparison revealed significantly lower scores in MVA groups (1.75±0.87) as compared to misoprostol group (I.99±1.32). Common side effects reported were mainly heavy bleeding (96.1% vs. 3.90%, P-value=0.001), normal bleeding(75.5% vs.24.5%, P-value=0.001*) fever (100% vs. 0%, P-value=0.001*), and chills (100% vs. 0%, P-value=0.001*). Efficacy rate in MVA group was significantly higher as compared to misoprostol group. In MVA group, efficacy was found in 269 (97.1%) patients whereas in misoprostol group efficacy was found in 260 (93.9%) patients. Conclusion: Oral misoprostol is as safe and acceptable as manual vacuum aspiration.

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