Madhual Niramaya, Tiwari Heena Dixit, Das Susmita, Kamboj Saloni, Thakkar Smit, Kashif Hala, Mahajan Akriti
Department of Obstetrics and Gynecology, Padmini Care, A Unit of DRIEMS Institute of Health Sciences and Hospital, Cuttack, Odisha, India.
Rashtriya Kishore Swasthya Karyakram Consultant, District Medical and Health Office, Visakhapatnam, Andhra Pradesh, India.
J Pharm Bioallied Sci. 2024 Feb;16(Suppl 1):S290-S292. doi: 10.4103/jpbs.jpbs_496_23. Epub 2024 Feb 29.
In the first trimester, almost one in five identified pregnancies end in spontaneous miscarriage, and another 22% result in induced abortion. After a spontaneous and/or induced abortion, there may be retained products of conception (POC). Because of its relatively poor efficacy and the unpredictability of the time interval until spontaneous evacuation, expectant treatment is not often chosen by healthcare professionals. In view of these facts, the current study's objective was to weigh the effectiveness of MVA and oral misoprostol 600 mg in managing incomplete abortion.
The investigation was conducted at the tertiary care center in India. The survey was conducted for one year. Subjects were selected from those attending the department for either spontaneous or induced abortions. A total of 230 women were randomly assigned to receive the interventions of a single dose of oral misoprostol 600 mcg or MVA. They were equally distributed to two groups and observed for the various parameters of success, signs and symptoms, satisfaction, and complications. The obtained values were compared statistically for the significance at <0.05 of values.
Of the 200 subjects (30 lost to follow-up), there was no significant variance in the demographics, clinical outcomes, and complications between the groups. However, the pain, fever, shivering, and satisfaction parameters were statistically variant between the groups. Fever, shivering, and pain were lower for the MISO subjects while satisfaction was reported higher from subjects in MISO group.
MISO and MVA are acceptable, safe, and efficient therapies for first-trimester un-complicated incomplete abortion. Nonetheless, misoprostol appears to be a marginally superior option to MVA in terms of accessibility, low therapy costs, reduced pain, and reduced demand for specialized personnel or equipment.
在孕早期，几乎五分之一已确认的妊娠以自然流产告终，另有22%以人工流产告终。自然流产和/或人工流产后，可能会有妊娠物残留（POC）。由于其疗效相对较差，且直到自然排出的时间间隔不可预测，医疗保健专业人员通常不选择期待治疗。鉴于这些事实，本研究的目的是权衡手动真空吸引术（MVA）和口服600毫克米索前列醇在处理不完全流产方面的有效性。
调查在印度的三级护理中心进行。调查持续了一年。研究对象选自到该科室进行自然流产或人工流产的患者。共有230名女性被随机分配接受单剂量600微克口服米索前列醇或MVA的干预措施。她们被平均分为两组，并观察成功、体征和症状、满意度及并发症的各项参数。对获得的值进行统计学比较，以确定P值<0.05时的显著性。
在200名受试者中（30名失访），两组在人口统计学、临床结局和并发症方面没有显著差异。然而，两组在疼痛、发热、寒战和满意度参数方面存在统计学差异。米索前列醇组的发热、寒战和疼痛较低，而米索前列醇组受试者的满意度较高。
米索前列醇和MVA是孕早期无并发症的不完全流产可接受、安全且有效的治疗方法。尽管如此，就可及性、低治疗成本、减轻疼痛以及对专业人员或设备的需求减少而言，米索前列醇似乎是比MVA略优的选择。
