Introduction of the dilation and evacuation procedure for second-trimester abortion in Vietnam using manual vacuum aspiration and buccal misoprostol.
BACKGROUND
The dilation and evacuation (D&E) procedure was modified for use in a low-resource setting where access to electric vacuum aspiration is limited.


METHODS
In this demonstration project, buccal misoprostol is used for cervical preparation, followed by evacuation using manual vacuum aspiration (MVA) and forceps. Senior physicians at the Hanoi Obstetrics and Gynecology Hospital were trained in D&E and subsequently conducted 439 D&E procedures.


RESULTS
The primary outcomes were efficacy and safety. Secondary outcome measures include efficacy of buccal misoprostol for cervical preparation prior to D&E and the feasibility of MVA for use in the D&E procedure.


CONCLUSIONS
Successful abortion took place in 100% of the cases. Three major complications occurred. This procedure may be appropriate in other low-resource settings lacking safe, effective abortion services in the second trimester.
Castleman
Laura D
LD
Ipas, Chapel Hill, NC, 27516, USA. castlemanl@ipas.org
Oanh
Khuat Thi Hai
KT
Hyman
Alyson G
AG
Thuy
Le Thanh
le T
Blumenthal
Paul D
PD
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000278:Administration, Buccal; D000293:Adolescent; D000328:Adult; D004107:Dilatation and Curettage / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016896:Treatment Outcome; D014619:Vacuum Curettage / Q000379:methods*; D014744:Vietnam
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol