177160 Using multiple data sources to understand the impact of misoprostol on reports of abortion complications in Mexican hospitals

Monday, October 27, 2008

Diana Lara, MD, MS , Reproductive Health Program, Population Council, Mexico City, Mexico
Sandra Garcia, ScD, ScM , Mexico Office, Population Council, Mexico City, Mexico
Fátima Juárez, PhD , Center for Demographic and Urban Planning Studies, Colegio de México, Mexico City, Mexico
Susheela Singh, PhD , The Guttmacher Institute, New York, NY
Objective

We aim to analyze complementary data sources to better understand the implications of misoprostol self-use on actual hospital abortion complication rates reported in two Mexican states – Chiapas and Guanajuato in 2005.

Methods:

We analyzed data from four sources: 1) objective data on recent trends in overall sales of misoprostol in Guanajuato and Chiapas; 2) “real-life” experiences of mock pharmacy clients who seek to obtain misoprostol over-the-counter in a random sample of pharmacies in Chiapas and Guanajauto; 3) specific, key information derived from a quantitative face to face survey with health professionals - in these states; and 4) reported rates of abortion-related hospital complications. Using explicit assumptions, we triangulated information to estimate the number and rates of abortions induced by misoprostol, and the proportion of hospital abortion complications associated with misoprostol use.

Results:

The number of abortions caused by misoprostol - in Guanajuato in 2005 ranged from 3,798 to 5,621 and in Chiapas from 12,057 to 29,419; rates of abortions induced by misoprostol per 1,000 women at reproductive age, ranged in Guanajuato from 2.7 to 4.1 and in Chiapas from 10.5 to 25.8; and the proportion of hospital abortion complications associated with misoprostol use was 16% in Chiapas and 4% in Guanajuato.

Conclusion:

Hospital abortion complications associated with misoprostol are higher in Chiapas than in Guanajato, and may be related to relatively greater sales of misoprostol in per-pill and individually-prepared bottles. Compared to Guanajuato, individuals in Chiapas tended to have more knowledge -- about misoprostol'sabortifacient properties and effective doses to induce abortion.

Learning Objectives:
1) Describe the trends in misoprostol sells and hospital abortion complications in two Mexican States (Guanajuato and Chiapas) and at national level 2) Describe misoprostol recommendation practices at pharmacies in Guanajuato and Chiapas 3) Assess the implications of misoprostol self-use on actual hospital abortion complication rates reported in two Mexican states – Chiapas and Guanajuato

Keywords: Abortion, Pharmacies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the designing of the study and instruments. I supervised field work. I conducted part of the data analysis and I participate in the writting of the manuscript.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Abortion Related Topics
See more of: Population, Family Planning, and Reproductive Health