J Obstet Gynaecol India. 2016 Aug;66(4):239-43.

A study of incomplete abortion following medical method of abortion (MMA )

Pawde AA, Ambadkar A and Chauhan AR

Abstract

Background: Medical method of abortion (MMA) is a safe, efficient, and affordable method of abortion. However, incomplete abortion is a known side effect.

Objective: To study incomplete abortion due to medication abortion and compare to spontaneous incomplete abortion and to study referral practices and prescriptions in cases of incomplete abortion following MMA.

Methods: Prospective observational study of 100 women with first trimester incomplete abortion, divided into two groups (spontaneous or following MMA), was administered a questionnaire which included information regarding onset of bleeding, treatment received, use of medications for abortion, its prescription, and administration. Comparison of two groups was done using Fisher exact test (SPSS 21.0 software).

Results: Thirty percent of incomplete abortions were seen following MMA; possible reasons being self-administration or prescription by unregistered practitioners, lack of examination, incorrect dosage and drugs, and lack of follow-up. Complications such as collapse, blood requirement, and fever were significantly higher in these patients compared to spontaneous abortion group.

Conclusion: The side effects of incomplete abortions following MMA can be avoided by the following standard guidelines. Self medication, over- the-counter use, and prescription by unregistered doctors should be discouraged and reported, and need of follow-up should be emphasized.

Comment: This paper shows that medical abortion, although safe and effective, absolutely needs to be prescribed by a trained provider, with the correct instructions. If not, then a safe and effective method can turn into an unsafe one (HMV)