title: Misoprostol as first-line treatment for incomplete abortion at a secondary-level health facility in Nigeria.
abstract: OBJECTIVE
  To determine the feasibility of introducing misoprostol as first-line treatment for incomplete abortion at a secondary-level health facility.
  
  
  METHODS
  An open-label prospective study was conducted in a secondary-level health facility in Nigeria. Eligible women diagnosed with incomplete abortion received 400-μg sublingual misoprostol as first-line treatment. Nurse-midwives took the lead in diagnosis, counseling, treatment, and assessment of final outcome. The primary outcome was the proportion of women who completed the abortion process.
  
  
  RESULTS
  Complete evacuation was achieved in 83 of 90 (92.2%) eligible women. The most common adverse effects were abdominal pain/cramps (58 [64.4%]), heavy bleeding (21 [23.3%]), spotting (15 [16.7%]), and fever/chills (11 [12.2%]). More than 90% of women reported that the procedure was satisfactory, that pain and adverse effects were tolerable, and that bleeding was acceptable. Eighty-four (93.3%) and 86 (95.6%) women, respectively, would use the method in the future and recommend it to friends.
  
  
  CONCLUSIONS
  Misoprostol is an effective, safe, and acceptable method for treating incomplete abortion. It can be successfully used as first-line treatment by nurse-midwives. Success rates over 90% are consistent with findings from previous studies in which drug administration was controlled solely by physicians.
authors.affiliation: Department of Obstetrics and Gynecology, University College Hospital, Ibadan, Nigeria.
authors.forename: Adeniran O
authors.initials: AO
authors.lastname: Fawole
authors.forename: Ayisha
authors.initials: A
authors.lastname: Diop
authors.forename: Alaruru O
authors.initials: AO
authors.lastname: Adeyanju
authors.forename: Oyewole T
authors.initials: OT
authors.lastname: Aremu
authors.forename: Beverly
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000027:Abortion, Incomplete / Q000188:drug therapy*; D000286:Administration, Sublingual; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009549:Nigeria; D009721:Nurse Midwives / Q000458:organization & administration*; D024802:Nurse's Role; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol