R K Deora, Tanmay Mathur, Divya Mittal
Abstract: Background and Objective: The objective of this study was to compare the efficacy and complication of medical method versus manual vacuum aspiration in early pregnancy termination to determine whether medical method of abortion represent a reasonable alternative to manual vacuum aspiration (surgical method) in terms of complete evacuation of products of conception and their side-effects. Method: A prospective comparative study was carried out on 212 pregnancies in women who were willing for termination of pregnancy upto 9 weeks (63 days) of gestational age, in Group A: women who opted for medical method for termination, Group B: women who opted for manual vacuum aspiration for termination during a period of 1 year (January 2019 to December 2019). Results: The mean age in Group A was 28.62 3.40 years and in Group B it was 29.36 3.83. In Group A 52.83 % belong to age group 21-25 and in Group B 46.22 % of patient belong to age group 21-25.. In Group A 94 (88.67 %) and in Group B 95 (89.62 %) people reside in urban area. Majority of the patients were multipara in which 29.71 % patients were Para 1, 48.16 % were para 2 and 38.06 % were belonging to higher parity and only 3.30 % patients were nullipara. Maximum number of cases in both the groups belonged to 6-7 weeks of gestation Group A- 45.28 % and in Group B-43.39 %. Average duration of bleeding P.V. in Group A = 8.723.46 days and Group B = 6.782.72 days. Incidence of pain, nausea, vomiting and diarrhea was 73.58 %, 32.07 %, 15.09 % and 11.32 % in Group A and 52.83 %, 7.54 %, 3.77 % and nil in Group B. Success rate was 92.45 % for medical abortion and 98.11 % for manual vacuum aspiration. Conclusion: Medical method of abortion for termination of pregnancy upto 9 weeks of gestation can be a better alternative to surgical method i.e., manual vacuum aspiration. Side effects like nausea, vomiting, pain abdomen and diarrhea were more with medical method but majority of these symptoms were self-limiting. Amount and duration of bleeding per vaginum is more in medical method as compared to surgical method. Medical method of abortion proves to be safer, confidential and economical method that avoids complication associated with surgical method eg Uterine perforation, Cervical injury, Anaesthetic complications. The effectiveness of medical method of abortion in present study was 92.45 % and success rate of manual vacuum aspiration was 98.11 %. The major disadvantage with medical method of abortion was the lack of predictability. The main advantage with manual vacuum aspiration was short duration of procedure.
Keywords: Abortion, Misoprostol, Mifepristone, Manual vacuum aspiration