NIGERIA – Trends in misoprostol use and abortion complications: a cross-sectional study from nine referral hospitals in Nigeria

by Folasade Adenike Bello, Bukola Fawole, Babawale Oluborode, et al

PLOS ONE 2018;13(12):e0209415. 31 December 2018. (Open access)


A cross-sectional study at nine referral hospitals in south-west Nigeria aimed to assess the use of misoprostol and complications associated with abortions in referral hospital. Nine years’ data were retrieved from medical records, including 699 induced abortions amongst 2,463 abortions found in records. Independent variable was the method of abortion; dependent variables were complications, need for treatment and mortality. Statistical significance was tested with Chi-square, Fishers’ exact and chi-square for trend tests (p<0.05). Nearly 70% of abortions were surgical abortions, but misoprostol use significantly increased over the study period in a linear trend. Patients who used misoprostol were significantly less likely to have infectious morbidity, genital tract injuries or medical complications. There was no difference in incomplete abortion in the groups. Patients were more likely to have in-patient care with surgical abortions (p<0.001), and to need prolonged antibiotic regimens (p=0.003), further surgery or additional specialist care (p=0.009).


Misoprostol abortion has significantly increased over time, and was associated with less morbidity and less need for further treatment. It appears to be the safer option.