Eficácia, segurança e aceitabilidade no tratamento do abortamento incompleto: revisão sistemática da literatura

Abstract

Abortion is defined as spontaneous or induced termination of pregnancy before fetal viability that can increase maternal morbidity and mortality, especially in low resource countries. Objectives: to evaluate effectiveness, safety and acceptability of treatments available to incomplete abortion up to 12 weeks (clinical or surgical). Methodology: Systematic review of randomized clinical trials. We selected studies that assessed effectiveness, acceptability and safety of treatments available to incomplete abortion. We considered the following outcomes: effectiveness (measured by absence of surgical intervention after the procedure); safety (measured by the presence of adverse events: hospitalization, blood transfusion or death) and acceptability (measured by general satisfaction of women regarding the service provided by the health professional). A systematic review of literature was performed from PubMed, Scielo, Lilacs, MEDLINE, Cochrane and ClinicalTrials.gov database using the following keywords and their combinations: “misoprostol”, “intrauterine manual aspiration”, “curettage”, “randomized clinical trial”. Only abstracts or articles published from January 2003 to October 2018 were considered. Results: The search resulted in 2549 articles. 2534 were excluded: 348 duplicated articles (articles that were found in more than one database), 1998 after title reading, 186 after abstract reading. 25 needed full text analysis. After title, abstract and full text analysis 15 articles were included in this review. Conclusion: The clinical treatment using misoprostol is a viable alternative to surgical procedures in the treatment of incomplete abortion, especially in low resource countries.