Introducing Misoprostol for the Treatment of Incomplete Abortion in Nigeria

Talemoh Dah, Akinsewa Akiode, Paschal Awah, Tamara Fetters, Mathew Okoh, Innocent Ujah, Ejike Oji

Abstract

Despite legal restriction, induced abortions and resulting complications are common in Nigeria.  Misoprostol administration for incomplete abortion was introduced in 3 Nigerian hospitals. The feasibility of the hospitals, patient and provider acceptability were assessed using questionnaire and interview guides administered to 205 women and 17 providers respectively.  Amongst the women, 194 (95%) were satisfied and very satisfied with misoprostol, 176 (86%) would choose misoprostol again if another incomplete abortion occurred and 191 (93%) would recommend it to another woman in a similar situation.  Providers were highly satisfied with misoprostol. The ease of use and ability to redirect surgical resources to more complicated issues were positive features cited by them.  The providers agreed that integration of misoprostol was straightforward and required few resources. Therefore, misoprostol for incomplete abortion is safe, efficacious and acceptable to providers and patients. In remote areas of Nigeria with limited post-abortion care (PAC), misoprostol administration is an important potential PAC treatment modality. Features of misoprostol-low cost, room temperature stability, and ease of introduction-render it an important treatment option, particularly in low resource and rural settings (Afr J Reprod Health 2011; 15[4]: 42-50).

 

Résumé

Introduction de Misoprostol pour le traitement de l’avortement inachevé au Nigéria. Malgré la limitation judiciaire, les avortements provoqués et les implications éventuelles sont communs au Nigéria.  L’administration de Misoprostol pour l’avortement inachevé a été introduite dans trois hôpitaux nigérians.  Nous avons évalué la faisabilité des hôpitaux, l’acceptabilité des patientes et des dispensateurs é l’aide des questionnaires et des interviews auprès des 205 femmes et 17 dispensateurs respectivement.  Parmi les femmes, 194 (95%) ont été satisfaites et très satisfaites de Misoprostol.  176 (86%) choisiraient Misoprostol encore si elles subissent un autre avortement inachevé et 191 (93%) le proposeraient aux autres  femmes qui se trouvent dans une situation pareille.  Les dispensateurs étaient hautement satisfaits de Misoprostol.  La facilité de l’utilisation  et la capacité de réorienter les ressources chirurgicales vers les problèmes  plus compliqués constituent des qu’elles ont citées.  Les dispensateurs étaient d’accord que l’intégration de Misoprostol est facile et ne demande que peu de ressources.  En conséquence, Misoprostol  n’est pas dangereux  pour le traitement de l’avortement inachevé, il est efficace et acceptable aux dispensateurs  et aux patientes.  Dans les régions rurales isolées au Nigéria, qui  ne disposent que très peu de soins du post-avortement (SPA) limités, l’administration de Misoprostol est une modalité de traitement du SPA potentiel important.  Les caractéristiques de Misoprostol : bon marché, stabilité à la température ordinaire et la facilité de l’introduction, le rend une option de traitement importante, surtout dans les milieux é faibles revenus et dans les régions rurales (Afr J Reprod Health 2011; 15[4]: 42-50).

 

  Keywords: Misoprostol, Post-abortion care, Unsafe abortion, Maternal mortality, Nigeria

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