CLINICAL ARTICLE Comparison of misoprostol and manual vacuum aspiration for the treatment of incomplete abortion C. Bique a , M. Ustá a , B. Debora a , E. Chong b, ⁎ , E. Westheimer b , B. Winikoff b a José Macamo Hospital, Maputo, Mozambique b Gynuity Health Projects, New York, NY, USA Received 19 March 2007; received in revised form 30 April 2007; accepted 2 May 2007 Abstract Objective: To compare the safety, efficacy, and acceptability of misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion in Maputo, Mozambique. Methods: A total of 270 women with clinically diagnosed incomplete abortions of up to 12 weeks of gestation were randomized to either 600 μg oral misoprostol or MVA. Women were followed-up seven days later to evaluate whether the abortion was complete. Results: Success was high for both MVA and misoprostol groups (100% vs 91%, P =0.002). Women in the MVA arm reported fewer side effects but higher pain scores. Women who received misoprostol were significantly more likely to be “very satisfied” with the treatment and willing to choose the method again. Conclusion: Although oral misoprostol was less effective than MVA in this study, it was more acceptable to women. Misoprostol is well-suited for use in low-resource settings, and should be promoted as an option for the treatment of incomplete abortion. © 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. KEYWORDS Misoprostol; Incomplete abortion; Mozambique; Miscarriage 1. Introduction Early pregnancy failure causes millions of women to seek emergency medical services. Estimates based on figures for the year 2000 indicate that of 210 million pregnancies worldwide, approximately 32 million ended in miscarriage and stillbirth, and another 46 million ended in induced abortion [1]. Nearly half of induced abortions (19 million) were considered to be unsafe (performed by unskilled providers or under unhygienic conditions, or both) and resulted in 67,900 deaths [2]. In Mozambique, abortion is available only under restricted conditions, thus many women attempt to terminate their pregnancies clandestinely with traditional practitioners, and later present to health care facilities with an incomplete abortion. Under a 1981 decree from the Ministry of Health, abortion is permitted in hospitals in cases of endangerment of health and contra- ceptive failure, and requires a committee to confirm whether legal grounds exist [3]. Although the decree has ⁎ Corresponding author. 15 East 26th St., #1617, NY NY 10010, USA. Tel.: +1 212 448 1230; fax: +1 212 448 1260. E-mail address: echong@gynuity.org (E. Chong). 0020-7292/$ – see front matter © 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2007.05.003 available at www.sciencedirect.com www.elsevier.com/locate/ijgo International Journal of Gynecology and Obstetrics (2007) 98, 222–226