Physicians' approaches to post-abortion care in Manila, Philippines.
OBJECTIVE
To assess the knowledge and practice of health professionals in Manila, Philippines, regarding methods used for uterine evacuation in post-abortion care (PAC), including the use of misoprostol.


METHODS
A purposive sample of physicians providing PAC services completed questionnaires anonymously about PAC practices.


RESULTS
Among 45 survey respondents, the primary methods used for first-trimester uterine evacuation in PAC included sharp curettage (n=45, 100%) and manual vacuum aspiration (MVA; n=38, 84.4%), which was consistent with their preferences. Misoprostol was prescribed for first-trimester post-abortion uterine evacuation by 55.6% (n=25) of respondents; dosing regimens ranged from 50 to 200 microg as a single dose or repeated every 4-24 hours. Of the respondents, 91.1% (n=41) prescribed misoprostol for obstetric indications, including labor induction and postpartum hemorrhage.


CONCLUSIONS
Most respondents used sharp curettage and MVA for first-trimester post-abortion uterine evacuation, and did not express a clear preference for either method. Despite the unregistered status of misoprostol, it was used in obstetrics and PAC by a majority of study respondents. The doses of misoprostol used for post-abortion uterine evacuation are lower than those recommended by evidence-based studies. The results indicate the need to disseminate evidence-based information about safe and effective use of MVA and misoprostol for PAC to physicians in Manila, Philippines.
Cansino
Catherine
C
Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA. ccansino@yahoo.com
Melgar
Junice Lirza
JL
Burke
Anne
A
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000627:therapeutic use; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D000359:Aftercare / Q000379:methods; D003625:Data Collection; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use; D010679:Philippines; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D006473:Postpartum Hemorrhage / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D014619:Vacuum Curettage / Q000379:methods
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol