in kuwait
abortion with misoprostol in Kuwait . Complications of self-induced medical
abortion with misoprostol
misoprostol (Cytotec) is a synthetic prostaglandin-E1
analogue which, is available in tablet form. It was
developed and marketed for the prevention of nonsteroidal anti-inflammatory drug-induced peptic ulcers.
The drug also has uterotonic effects and is increasingly
used to induce labor and abortion.
Abortion caused by
misoprostol may not be successful or may be incomplete
which could lead to potentially dangerous bleeding,
hospitalization, surgery, infertility, or maternal death. In
addition, in countries where abortion is illegal, selfabortion with misoprostol may lead to other
consequences. The objective of this study was to report
local complications after self-medication with
misoprostol.
Between January 2001 and May 2002, 4
pregnant women ages 19, 24, 27 and 30 years were seen
after self-induced medical abortion with misoprostol in
the first trimester.
They were married, and in stable
relationships. All the women got misoprostol from other
countries as it is not available to the public and is
prescribed only to women as inpatients in hospitals. Two
women used 4 tablets (800 mcg) of misoprostol
(Cytotec®; Searle Pharmaceutical, United Kingdom)
orally and the other two women used 2 tablets (400 mcg)
of misoprostol vaginally.
They continued to have vaginal
bleeding, pain, anxiety, and fear for 3-4 weeks. They
were not aware of the side-effects and complications of
self-induced medical abortion with misoprostol. Because
of the symptoms of anemia and significant blood loss
they sought medical advice. The hemoglobin was
between 6-7g/L.abortion with misoprostol in Kuwait
Transvaginal ultrasonography revealed abortion with misoprostol in Kuwait
“incomplete abortion.”They discharged themselves
against medical advice and were lost to follow-up.
In medical abortion practice, method failure is
considered to occur when a woman needs a surgical
evacuation to complete the abortion for any reason
(including incomplete abortion, viable pregnancy,
hemorrhage, and patient request). Approximately 2-10%
of women who have a medical abortion will need
surgical aspiration.
abortion with misoprostol in Kuwait
A distinction must be made between
true drug failure and the usual course of medical
abortion. Women may continue to bleed for 3-5 weeks
after the use of mifeprostone and vaginal misoprostol.2
Ultrasonography may even reveal heterogeneous
intracavity echoes consisting of blood, blood clots, and
deciduas. In the absence of heavy vaginal bleeding, it is
recommended that such women should be followed
conservatively.
abortion with misoprostol in Kuwait
Care providers are requested to counsel
women about delayed and prolonged bleeding before
medical abortion and to be available to do dilatation and
curettage if necessary.3 abortion with misoprostol in Kuwait
However, in countries where abortion with misoprostol in Kuwait
abortion is illegal, women do not have the resources and
the necessary knowledge before having medical