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Replacement of dilation and curettage/evacuation by manual vacuum aspiration and medical abortion, and the introduction of postabortion contraception in Pakistan
Author(s) -
Zaidi Shahida,
Yasmin Haleema,
Hassan Lubna,
Khakwani Mehnaz,
Sami Shehla,
Abbas Tazeen
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.03.016
Subject(s) - medicine , vacuum aspiration , dilation and curettage , curettage , abortion , gynecology , medical abortion , obstetrics , dilation (metric space) , family planning , surgery , general surgery , pregnancy , research methodology , population , misoprostol , environmental health , biology , genetics , mathematics , combinatorics
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%.