Replacement of dilation and curettage/evacuation by manual vacuum aspiration and medical abortion, and the introduction of postabortion contraception in Pakistan

Abstract Manual vacuum aspiration (MVA) and medical abortion were introduced to replace dilation and curettage/evacuation for incomplete abortions, and postabortion contraception was provided in 5 selected public hospitals in Pakistan. In the largest hospital, an Ipas MVA training center since 2007,...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2014-07, Vol.126 (S1), p.S40-S44
Main Authors: Zaidi, Shahida, Yasmin, Haleema, Hassan, Lubna, Khakwani, Mehnaz, Sami, Shehla, Abbas, Tazeen
Format: Article
Language:English
Subjects:
Abortifacient Agents, Nonsteroidal - administration & dosage
Abortion, Incomplete - therapy
Aftercare - methods
Contraception - methods
Dilatation and Curettage - methods
Dilatation and Curettage - statistics & numerical data
Dilation and curettage
Female
FIGO initiative
Gynecology - organization & administration
Hospitals, Public
Humans
Manual vacuum aspiration
Medical abortion
Misoprostol - administration & dosage
Obstetrics - organization & administration
Obstetrics and Gynecology
Pakistan
Postabortion contraception
Pregnancy
Prevention
Societies, Medical - organization & administration
Unsafe abortion
Vacuum Curettage - methods
Vacuum Curettage - statistics & numerical data
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Summary:Abstract Manual vacuum aspiration (MVA) and medical abortion were introduced to replace dilation and curettage/evacuation for incomplete abortions, and postabortion contraception was provided in 5 selected public hospitals in Pakistan. In the largest hospital, an Ipas MVA training center since 2007, MVA use reached 21% in 2008. After the International Federation of Gynecology and Obstetrics (FIGO) and UNFPA provided MVA kits, MVA use increased dramatically to 70% − 90% in 2010 − 2013. In 2 of the remaining 4 hospitals in which the Society of Obstetricians and Gynecologists of Pakistan trained doctors in May 2012 and January 2013, the target of having 50% of women managed by MVA and medical abortion (MA) was met; however, in the third hospital only 43% were treated with MVA and MA. In the fourth hospital, where misoprostol and electric vacuum aspiration use was 64% and 9%, respectively, before training, an MVA workshop introduced the technique. Postabortion contraception was provided to 9% − 29% of women, far below the target of 60%.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2014.03.016