Comparison of the Successful Outcome of Treatment with Oral Misoprostol with Manual Vacuum Aspiration in First Trimester Incomplete Miscarriage at Tertiary Care Hospital Abbottabad
DOI:
https://doi.org/10.70749/ijbr.v3i7.2331Keywords:
Incomplete Miscarriage, Misoprostol, Manual Vacuum Aspiration, First Trimester, Treatment EfficacyAbstract
Background: Incomplete miscarriage is a common complication of early pregnancy, requiring prompt and effective management to prevent complications and preserve future fertility. Both oral misoprostol and manual vacuum aspiration are established treatment options, but their comparative efficacy remains debated, making the choice between these modalities crucial for optimal patient care. Objective: To compare the successful outcome of treatment with oral misoprostol with manual vacuum aspiration in first trimester incomplete miscarriage at Tertiary Care Hospital, Abbottabad. Study Design: Randomized controlled trial. Duration and Place of Study: The study was conducted from February to May 2025 at the Department of Gynaecology and Obstetrics, Combined Military Hospital, Abbottabad, following approval of the synopsis. Methodology: This randomized controlled trial included 162 women with first trimester incomplete miscarriage, with 81 participants allocated to each treatment group. Sample size was calculated using OpenEpi software with 95% confidence level and 80% study power, based on previously reported success rates. Group A received oral misoprostol while Group B underwent manual vacuum aspiration. Treatment success was defined as complete evacuation without additional intervention. Results: Manual vacuum aspiration achieved significantly higher success rates compared to oral misoprostol (98.8% vs 82.7%, p<0.001). Mean age was 30.93±5.09 years versus 30.31±5.19 years respectively. Mean gestational age was 9.58±1.70 weeks versus 9.17±1.72 weeks. Conclusion: Manual vacuum aspiration is significantly more effective than oral misoprostol for managing first trimester incomplete miscarriage.
Downloads
References
1. Das, M., Patidar, H., & Singh, M. (2024). Understanding trimester-specific miscarriage risk in Indian women: Insights from the calendar data of national family health survey (NFHS-5) 2019-21. BMC Women's Health, 24(1).
https://doi.org/10.1186/s12905-023-02838-7
2. Khamees, D. A., & Al-Ouqaili, M. T. (2022). Cross-sectional study of chromosomal aberrations and immunologic factors in Iraqi couples with recurrent pregnancy loss. PeerJ, 10, e12801.
https://doi.org/10.7717/peerj.12801
3. Murugesu, S., Braun, E., Saso, S., & Bourne, T. (2024). Predictors of successful expectant and medical management of miscarriage: A systematic review. Acta Obstetricia et Gynecologica Scandinavica, 103(12), 2348-2372.
https://doi.org/10.1111/aogs.14934
4. Nasser, S., Makhdoom, T., Yahya Ahmad Alhubaishi, L., & Elbiss, H. M. (2024). Medical management of first trimester missed miscarriages - A cross-sectional study. Pakistan Journal of Medical Sciences, 40(7).
https://doi.org/10.12669/pjms.40.7.8751
5. Ratnam, S., Kulasingam, S., & Kanagallingam, A. (2023). Manual vacuum aspiration versus expectant management for first trimester miscarriage: A randomized controlled trial. Cureus.
https://doi.org/10.7759/cureus.45731
6. Chung, J. P., Fekadu, G., Sahota, D. S., Leung, T., & You, J. H. (2023). Ultrasound-guided manual vacuum aspiration (USG-MVA) with cervical preparation for early pregnancy loss: A cost-effectiveness analysis. PLOS ONE, 18(11), e0294058.
https://doi.org/10.1371/journal.pone.0294058
7. Kakinuma, T., Kakinuma, K., Kaneko, A., Kagimoto, M., Kawarai, Y., Ihara, M., Saito, K., Matsuda, Y., Ohwada, M., Tanaka, H., Takeshima, N., & Yanagida, K. (2022). Safety and efficacy of manual vacuum aspiration under local anesthesia compared to general anesthesia in the surgical management of miscarriage: A retrospective cohort study. Patient Safety in Surgery, 16(1).
https://doi.org/10.1186/s13037-022-00328-7
8. Chung, J. P., Chau, O. S., Law, T. S., Ng, K., Ip, P. N., Ng, E. Y., Tso, T. K., Sahota, D. S., & Li, T. C. (2023). Incidence of intrauterine adhesion after ultrasound-guided manual vacuum aspiration (USG-MVA) for first-trimester miscarriages: A prospective cohort study. Archives of Gynecology and Obstetrics, 309(2), 669-678.
https://doi.org/10.1007/s00404-023-07280-6
9. Jain, A., Singh, S., & Elliyas, S. (2021). Effectiveness of manual vacuum aspiration (MVA) device in the management of intrauterine copper devices (IUCD) with missing strings: A prospective interventional study. The Journal of Obstetrics and Gynecology of India, 71(4), 424-429.
https://doi.org/10.1007/s13224-021-01440-x
10. Wu, H., Marwah, S., Wang, P., Wang, Q., & Chen, X. (2017). Misoprostol for medical treatment of missed abortion: A systematic review and network meta-analysis. Scientific Reports, 7(1).
https://doi.org/10.1038/s41598-017-01892-0
11. Nomura, R. M. Y., Nakamura-Pereira, M., Nomura, R. M. Y., Brizot, M. de L., Trapani Júnior, A., Paro, H. B. M. da S., Rosas, C. F., Medeiros, R. D. de, Surita, F. G., Luz, A. G., Mattar, R., Ferreira, E. C., Alves, Á. L. L., Cordioli, E., Damásio, L. C. V. da C., Wender, M. C. O., & Braga, A. (2023). Misoprostol use in obstetrics: Number 6 - June 2023. Revista Brasileira de Ginecologia E Obstetrícia, 45, 356–367.
https://doi.org/10.1055/s-0043-1770931
12. Silva, T. M., Araujo, M. A., Simões, A. C., Oliveira, R. D., Medeiros, K. S., Sarmento, A. C., Medeiros, R. D., Costa, A. P., & Gonçalves, A. K. (2023). Efficacy, safety, and acceptability of Misoprostol in the treatment of incomplete miscarriage: A systematic review and meta-analysis. Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 45(12), e808-e817.
https://doi.org/10.1055/s-0043-1776029
13. Ambusaidi, Q., & Zutshi, A. (2015). Effectiveness of Misoprostol for induction of first-trimester miscarriages: Experience at a single tertiary care centre in Oman. Sultan Qaboos University Medical Journal, 15(4), e534-e538.
https://doi.org/10.18295/squmj.2015.15.04.016
14. Ibiyemi, K. F., Ijaiya, M. A., & Adesina, K. T. (2019). Randomised trial of oral Misoprostol versus manual vacuum aspiration for the treatment of incomplete abortion at a Nigerian tertiary hospital. Sultan Qaboos University Medical Journal, 19(1), e38-43.
https://doi.org/10.18295/squmj.2019.19.01.008
15. Shaheen, H., Khosa, M. S., & Hanif, H. I. N. A. (2017). Comparison of efficacy of manual vacuum aspiration (MVA) and medical treatment in the management of first trimester missed miscarriage. Pak J Med Health Sci, 11(1), 270-273.
16. Naseem, S., Akbar, S., Sumayya, Fayaz, F., & Amjid, U. (2024). Comparing the effectiveness of misoprostol with manual vacuum aspiration in treating first trimester miscarriages. Khyber Journal of Medical Sciences, 17(2), 104-110.
https://doi.org/10.70520/kjms.v17i2.553
17. Zaman, N., Zahoor, S., Zulfiqar, S., Afzal, R., Younus, S., & Zahoor, A. (2019). Comparison of misoprostol with manual vacuum aspiration for the management of incomplete miscarriage. Pak J Med Health Sci, 13(2), 637-9.
18. Das, C. M., Sharma, M., Pardeep, K., & Khurshid, F. (2014). To compare the safety and efficacy of manual vacuum aspiration with misoprostol (ST mom) 600mg in incomplete miscarriage. J Liaquat Uni Med Health Sci, 13(03), 93-96.
https://lumhs.edu.pk/jlumhs/Vol13No03/pdfs/2.pdf
19. Khan, B., Aziz, A., Parveen, S., Qureshi, H. Z., Imran, H., & Khan, M. (2024). Effectiveness of Misoprostol versus manual vacuum aspiration for the treatment of the first trimester pregnancy termination. Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University, 20(SUPPL-1), 454-458.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
