The Economic Burden of Abortion and Its Complication Treatment Cares: A Systematic Review

Movahed, Maryam Soleimani; Barghazan, Saeed Husseini; Askari, Fariba; Arab‐Zozani, Morteza

doi:10.18502/jfrh.v14i2.4354

Cited by 4 publications

(4 citation statements)

References 33 publications

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“…This clinical finding is critical because many serious problems can happen after an incomplete abortion, including pelvic infections, cervical damage, infertility, severe bleeding or sepsis, death, uterine rupture, uterine perforation, subsequent hysterectomy, failure of multiple organ systems, and/or mental effects [ 27 ]. Also, incompleted abortions must be treated surgically, medically, or expectantly [ 28 ]; therefore, the consensus is that abortion and post-abortion care place a significant financial burden on society [ 29 ]. However, another source of heterogeneity was the variations in the medical assessment of a complete miscarriage.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of isosorbide mononitrate plus misoprostol compared to misoprostol alone in the management of the first and second trimester abortion: a systematic review and meta-analysis

Makvandi,

Karimi,

Safyari

et al. 2024

BMC Pregnancy Childbirth

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Background However, misoprostol is often used to terminate a pregnancy, but it can also cause side effects. Isosorbide mononitrate (ISMN) can help the cervix mature by increasing the production of prostaglandin E2 and vasodilation. Considering that the results of studies in this field are contradictory, it is the purpose of this study to evaluate the efficacy and safety of vaginal ISMN plus misoprostol compared to misoprostol alone in the management of first- and second-trimester abortions. Method The search process was conducted for MEDLINE through the PubMed interface, Scopus, Web-of-Science, Science Direct, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform until November 10, 2023. Our assessment of bias was based on version 2 of the risk-of-bias tool (RoB2) for randomized trials and our level of evidence quality was determined by GRADE. Meta-analysis of all data was carried out using Review Manager (RevMan) version 5.1. Result Seven randomized clinical trials were included in the systematic review and three in the meta-analysis, with mixed quality. The results of the meta-analysis revealed that in the second-trimester abortion, the inclusion of ISMN in conjunction with vaginal misoprostol results in a noteworthy reduction in the induction abortion interval, specifically by 4.21 h (95% CI: -7.45 to -0.97, P = 0.01). The addition of vaginal ISMN to misoprostol, compared to vaginal misoprostol alone, increased the odds of a completed abortion by 3.76 times. (95% CI: 1.08 to 13.15, P = 0.04). Conclusion The findings of this study can offer valuable insights aimed at enhancing counseling and support for non-surgical methods of medication abortion within professional settings. Moreover, it improves the effectiveness of clinical treatment and reduces the occurrence of unnecessary surgical interventions in the abortion management protocol.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of isosorbide mononitrate plus misoprostol compared to misoprostol alone in the management of the first and second trimester abortion: a systematic review and meta-analysis

Makvandi,

Karimi,

Safyari

et al. 2024

BMC Pregnancy Childbirth

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“…[ 33 ] Routinely using antibiotic prophylaxis before surgical miscarriage management in order to prevent the infection complications was reported more effective and less expensive in less developed setting and would save millions of dollars for health-care systems. [ 4 16 ]…”

Section: Discussionmentioning

confidence: 99%

“…Postabortion care imposes a substantial economic burden on society, annual costs of abortion, and postabortion cares ranged from 189,000 $US to 134 million $US and $23 to $564 per patient costs worldwide. [ 3 4 5 ] Pregnancy termination management includes a wide range of conditions as follows; induced abortion, managing incomplete evacuation, control postpartum hemorrhage, treatment of spontaneous abortion, miscarriage management, treatment of early pregnancy failure, management of nonviable early pregnancy, and management of early pregnancy loss. [ 6 ]…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion

Barghazan

Hadian

Rezapour

et al. 2022

Journal of Education and Health Promotion

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Pregnancy termination and abortion-related complications are well-established problems among women at reproductive age and resulted in significant morbidity and mortality. Accordingly, a systematic study was performed to investigate the economic evaluation studies results on costs and benefits of medical and surgical abortion methods. PubMed, Web of Science, Scopus, Embase, Cochrane library, ProQuest, and ScienceDirect databases as well as Google scholar were searched through June 2021. Original full-text English language studies that performed an economic evaluation analysis comparing medical and surgical methods of pregnancy termination were included in this review. A critical quality assessment was conducted utilizing the Consolidated Health Economic Evaluation Standards checklist. The latest web-based tool adjusted the estimates of costs expressed in one specific currency and price year into a specific target currency (the year 2020 $US). Overall, 538 records were retrieved, and 20 studies were deemed eligible for qualitative synthesis. Among the reviewed studies, three studies investigated cost-minimization analysis, three studies investigated cost-utility analysis, and 14 studies investigated cost-effectiveness analysis. The directly comparison of medical with surgical abortion was most frequently studied. Medical abortion saved US$ 6 to US$ 2373 per patient's costs. Medical abortion was cost-effective and cost-saving option in compare to the surgical abortion across all perspectives (the incremental cost effectiveness ratio ranged from US$ 419 to US$ 4,044). Quality scores of included studies ranged from 54% to 100%, and 70% of studies received a score of above 85% and had “excellent” quality. According to the results, based on various economic and clinical effectiveness decision-making criteria used in different studies of health economic evaluation, the majority of research provided evidence on the advantage of pharmaceutical methods compared to surgical methods, as well as the advantages of using combinations therapy compared to single therapeutic interventions.

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“…[ 23 24 ] This puts them at an increased risk of unsafe abortions and insufficient postabortion care, which poses health risks and associated healthcare costs. [ 25 ] Measurement of abortion rates and associated factors in the hard-to-reach settings such as the FCs is essential in informing reproductive policies and programs that suit such unique settings. However, data on abortion rates in FCs are still few, and the associated factors are not clearly understood.…”

Section: Introductionmentioning

confidence: 99%

Abortion and its correlates among female fisherfolk along Lake Victoria in Uganda

Matovu

Nanvubya

Abaasa

et al. 2021

Journal of Family Medicine and Primary Care

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Introduction: In Uganda, people living in fishing communities tend to engage in high-risk sexual activity which leads to unintended pregnancies that may end in abortions. Abortion has negative social, psychological, and medical impacts. We determined the frequency of abortion and its correlates among female fisher-folk along Lake Victoria in Uganda. Methods: A cross-sectional survey was conducted among women aged 15– 49 years from Kigungu and Nsazi fishing communities. Data were collected on socio-demographic characteristics, abortion, and family planning use. Associations between abortion and participant characteristics were assessed using logistic regression models. Results: Of the 713 women interviewed, 36, 5% were pregnant and 247, 34.6 % were using contraception. Majority (600, 84.2%) of those interviewed reported ever being pregnant. Approximately 45% of the pregnancies were un-intended while a third of those who had ever been pregnant (195, 32.5%) reported having aborted before. Slightly over a third (247, 34.6%) reported currently using or ever using family planning. Women aged 30+ years were more likely to abort compared to those aged 15-29 years (aOR: 2.7; 95% CI: 1.23-5.91). Women who had living children were less likely to abort compared to those who didn’t have any living child (aOR: 0.06; 95% CI: 0.01 – 0.17). Conclusion: The rate of abortion among female fisher-folk in Uganda is substantial. Family planning use is still low and unintended pregnancies are common. Abortion risk increased with the age of the mother. Continuous behavioral change communication and optimization of family planning use are recommended to reduce abortions.

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The Economic Burden of Abortion and Its Complication Treatment Cares: A Systematic Review

Cited by 4 publications

References 33 publications

Efficacy and safety of isosorbide mononitrate plus misoprostol compared to misoprostol alone in the management of the first and second trimester abortion: a systematic review and meta-analysis

Efficacy and safety of isosorbide mononitrate plus misoprostol compared to misoprostol alone in the management of the first and second trimester abortion: a systematic review and meta-analysis

Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion

Abortion and its correlates among female fisherfolk along Lake Victoria in Uganda

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