Comparison of treatment of incomplete abortion with misoprostol by physicians and midwives at district level in Uganda: A randomised controlled equivalence trial

The Lancet

Volumn 385, Issue 9985, 2015, Pages 2392-2398

  Klingberg Allvin, Marie ^a,b   Cleeve, Amanda ^b   Atuhairwe, Susan ^d,f   Tumwesigye, Nazarius Mbona ^e   Faxelid, Elisabeth ^c   Byamugisha, Josaphat ^c,f   Gemzell Danielsson, Kristina ^b  

^a DALARNA UNIVERSITY   (Sweden)

^b KAROLINSKA INSTITUTE   (Sweden)

^c MULAGO HOSPITAL   (Uganda)

^d Makerere College of Health Sciences   (Uganda)

^e MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES   (Uganda)

^f KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

MISOPROSTOL; ABORTIVE AGENT;

ABDOMINAL PAIN; ADOLESCENT; ADULT; ARTICLE; CHILL; COMPARATIVE STUDY; CONTROLLED STUDY; FEMALE; FEVER; FIRST TRIMESTER PREGNANCY; HUMAN; INCOMPLETE ABORTION; MAJOR CLINICAL STUDY; MIDWIFE; MULTICENTER STUDY; NAUSEA; OUTCOME ASSESSMENT; PATIENT SAFETY; PHYSICIAN; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; UGANDA; VOMITING; ABORTION, INCOMPLETE; CLINICAL TRIAL; CURETTAGE; DEVELOPING COUNTRY; MIDDLE AGED; PREGNANCY; STATISTICS AND NUMERICAL DATA; YOUNG ADULT;

ABORTIFACIENT AGENTS, NONSTEROIDAL; ABORTION, INCOMPLETE; ADOLESCENT; ADULT; DEVELOPING COUNTRIES; FEMALE; HUMANS; MIDDLE AGED; MIDWIFERY; MISOPROSTOL; PHYSICIANS; PREGNANCY; PREGNANCY TRIMESTER, FIRST; UGANDA; VACUUM CURETTAGE; YOUNG ADULT;

EID: 84930927086     PISSN: 01406736     EISSN: 1474547X     Source Type: Journal    
DOI: 10.1016/S0140-6736(14)61935-8     Document Type: Article

References (32)

1. B Ganatra, Ö Tuncalp, HB Johnston, BR Johnson Jr, AM Gülmezoglu, M Temmerman From concept to measurement: operationalizing WHO's definition of unsafe abortion Bull World Health Organ 92 2014 155
2. IH Shah, E Åhman, N Ortayli Access to safe abortion: progress and challenges since the 1994 International Conference on Population and Development (ICPD) Contraception 2014 10.1016/j.contraception.2014.04.004 published online April 13.
3. WHO UNICEF UNFPA The World Bank UNPD Trends in maternal mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division 2013 World Health Organization Geneva
4. V Rasch Unsafe abortion and postabortion care - an overview Acta Obstet Gynecol Scand 90 2011 692 700
5. I Escandon, K Turner Indicators for the essential elements of postabortion care PAC Consortium 2006
6. A Weeks Clarifying the role of misoprostol in obstetrics Afr Health Sci 1 2001 52 54
7. A Weeks, G Alia, J Blum et al. A randomized trial of misoprostol compared with manual vacuum aspiration for incomplete abortion Obstet Gynecol 106 2005 540 547
8. K Gemzell-Danielsson, C Fiala, A Weeks Misoprostol: first-line therapy for incomplete miscarriage in the developing world BJOG 114 2007 1337 1339
9. JP Neilson, GM Gyte, M Hickey, JC Vazquez, L Dou Medical treatments for incomplete miscarriage Cochrane Database Syst Rev 3 2013 CD007223
10. T Shochet, A Diop, A Gaye et al. Sublingual misoprostol versus standard surgical care for treatment of incomplete abortion in five sub-Saharan African countries BMC Pregnancy Childbirth 12 2012 127
11. R Dabash, MC Ramadan, E Darwish, N Hassanein, J Blum, B Wikinoff A randomized controlled trial of 400-μg sublingual misoprostol versus manual vacuum aspiration for treatment of incomplete abortion in two Egyptian hospitals Int J Gynaecol Obstet 111 2010 131 135
12. B Dao, J Blum, B Thieba et al. Is misoprostol safe, effective and acceptable alternative to manual vacuum aspiration for postabortion care? Results from a randomised trial in Burkina Faso, West Africa BJOG 114 2007 1368 1375
13. J Yarnall, Y Swica, B Winikoff Non-physician clinicians can safely provide first trimester medical abortion Reprod Health Matters 17 2009 61 69
14. A Gessessew, GA Barnabas, N Prata, K Weidert Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care Int J Gynaecol Obstet 113 2011 28 31
15. M Paul, K Gemzell-Danielsson, C Kiggundu, R Namugenyi, M Klingberg-Allvin Barriers and facilitators in the provision of post-abortion care at district level in central Uganda - a qualitative study focusing on task sharing between physicians and midwives BMC Health Serv Res 14 2014 28
16. BD Fulton, RM Scheffler, SP Sparkes, EY Auh, M Vujicic, A Soucat Health workforce skill mix and task shifting in low income countries: a review of recent evidence Hum Resour Health 9 2011 1
17. C Pereira, G Mbaruku, C Nzabuhakwa, S Bergstrom, C McCord Emergency obstetric surgery by non-physician clinicians in Tanzania Int J Gynaecol Obstet 114 2011 180 183
18. H Nabudere, D Asiimwe, R Mijumbi Task shifting in maternal and child health care: an evidence brief for Uganda Int J Technol Assess Health Care 27 2011 173 179
19. G Piaggio, DR Elbourne, SJ Pocock, SJ Evans, DG Altman Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement JAMA 308 2012 2594 2604
20. KL Turner, A Huber Woman-centered, comprehensive abortion care: trainer's manual 1st edn. 2004 Ipas Chapel Hill, NC
21. KL Turner Medical abortion training guide 2nd edn. 2010 Ipas Chapel Hill, NC
22. J Blum, B Winikoff, K Gemzell-Danielsson, PC Ho, R Schiavon, A Weeks Treatment of incomplete abortion and miscarriage with misoprostol Int J Gynaecol Obstet 99 2007 186 189
23. WHO Safe abortion: technical and policy guidance for health systems 2012 World Health Organization Geneva
24. A Gaye, A Diop, T Shochet, B Winikoff Decentralizing postabortion care in Senegal with misoprostol for incomplete abortion Int J Gynaecol Obstet 126 2014 223 226
25. MJ Renfrew, A McFadden, MH Bastos et al. Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care Lancet 384 2014 1129 1145
26. IK Warriner, O Meirik, M Hoffman et al. Rates of complication in first-trimester manual vacuum aspiration abortion done by doctors and mid-level providers in South Africa and Vietnam: a randomised controlled equivalence trial Lancet 368 2006 1965 1972
27. IK Warriner, D Wang, NT Huong et al. Can midlevel health-care providers administer early medical abortion as safely and effectively as doctors? A randomised controlled equivalence trial in Nepal Lancet 377 2011 1155 1161
28. H Kopp Kallner, R Gomperts, E Salomonsson, M Johansson, L Marions, K Gemzell-Danielsson The efficacy, safety and acceptability of medical termination of pregnancy provided by standard care by doctors or by nurse-midwives: a randomised controlled equivalence trial BJOG 2014 10.1111/1471-0528.12982 published online July 18.
29. RM Renner, D Brahmi, N Kapp Who can provide effective and safe termination of pregnancy care? A systematic review BJOG 120 2013 23 31
30. M Vlassoff, F Mugisha, A Sundaram et al. The health system cost of post-abortion care in Uganda Health Policy Plan 29 2014 56 66
31. LB Haddad, NM Nour Unsafe abortion: unnecessary maternal mortality Rev Obstet Gynecol 2 2009 122 126
32. M Berer Provision of abortion by mid-level providers: international policy, practice and perspectives Bull World Health Organ 87 2009 58 63