Misoprostol and illegal abortion in Fortaleza, Brazil. 1993

H L Coêlho, and A C Teixeira, and A P Santos, and E B Forte, and S M Morais, and C La Vecchia, and G Tognoni, and A Herxheimer
Department of Pharmacy, Federal University of Ceará, Fortaleza, Brazil.

Misoprostol, a prostaglandin E1 analogue indicated for ulcer treatment, has been widely used as an abortifacient by women in Brazil, where abortion is legal only in cases of rape or incest, or to save the woman's life. Because misoprostol is an inefficient abortifacient, many women who use it have incomplete abortions and need uterine evacuation. We reviewed the records of women admitted to the main obstetric hospital of Fortaleza, capital of Ceará state, Brazil, between January, 1990, and July, 1992, for uterine evacuation after induced abortion. The number of incomplete abortions induced by misoprostol increased substantially during the first half of 1990, and declined thereafter. Of the 593 cases in 1991, 75% were related to misoprostol, 10% to the use of other specified drugs, and 6% to unspecified drugs. For the remaining 9% the procedure used was not recorded; these included 3% in whom abortion had been induced by a clandestine abortionist. The number of uterine evacuations per month fell from 89 in August, 1990, to 62 in July, 1991, when sales of misoprostol in Ceará state were suspended. The fall continued after the sale of misoprostol ceased, to about 20 cases in December, 1991; numbers remained around this level until June, 1992, sustained by clandestine sales. The lack of access to contraception is the main reason for the large numbers of unplanned pregnancies and is a major public health issue for Brazilian women. The prohibition of abortion creates a void in which misuse of medicines is one extra complication, mainly because of the poor control of drug marketing.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001938 Brazil A country located on the eastern coast of South America, located between Colombia and Peru, that borders the Atlantic Ocean. It is bordered on the north by Venezuela, Guyana, Suriname, and French Guiana, on the south by Uruguay, and on the west by Argentina. The capital is Brasilia.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000019 Abortifacient Agents Chemical substances that interrupt pregnancy after implantation. Abortifacient Effect,Abortifacient Effects,Abortifacients,Contraceptive Agents, Postconception,Agents, Abortifacient,Agents, Postconception Contraceptive,Effect, Abortifacient,Effects, Abortifacient,Postconception Contraceptive Agents
D000024 Abortion, Criminal Illegal termination of pregnancy. Abortion, Illegal,Illegal Abortion,Abortions, Criminal,Abortions, Illegal,Criminal Abortion,Criminal Abortions,Illegal Abortions
D000027 Abortion, Incomplete Premature loss of PREGNANCY in which not all the products of CONCEPTION have been expelled. Miscarriage, Missed,Abortions, Incomplete,Incomplete Abortion,Incomplete Abortions,Miscarriages, Missed,Missed Miscarriage,Missed Miscarriages
D000028 Abortion, Induced Intentional removal of a fetus from the uterus by any of a number of techniques. (POPLINE, 1978) Embryotomy,Abortion (Induced),Abortion Failure,Abortion History,Abortion Rate,Abortion Technics,Abortion Techniques,Abortion, Drug-Induced,Abortion, Rivanol,Abortion, Saline-Solution,Abortion, Soap-Solution,Anti-Abortion Groups,Fertility Control, Postconception,Induced Abortion,Previous Abortion,Abortion Failures,Abortion Histories,Abortion Rates,Abortion Technic,Abortion Technique,Abortion, Drug Induced,Abortion, Previous,Abortion, Saline Solution,Abortion, Soap Solution,Abortions (Induced),Abortions, Drug-Induced,Abortions, Induced,Abortions, Previous,Abortions, Rivanol,Abortions, Saline-Solution,Abortions, Soap-Solution,Anti Abortion Groups,Anti-Abortion Group,Drug-Induced Abortion,Drug-Induced Abortions,Embryotomies,Failure, Abortion,Failures, Abortion,Group, Anti-Abortion,Groups, Anti-Abortion,Histories, Abortion,History, Abortion,Induced Abortions,Postconception Fertility Control,Previous Abortions,Rate, Abortion,Rates, Abortion,Rivanol Abortion,Rivanol Abortions,Saline-Solution Abortion,Saline-Solution Abortions,Soap-Solution Abortion,Soap-Solution Abortions,Technic, Abortion,Technics, Abortion,Technique, Abortion,Techniques, Abortion
D000282 Administration, Intravaginal The insertion of drugs into the vagina to treat local infections, neoplasms, or to induce labor. The dosage forms may include medicated pessaries, irrigation fluids, and suppositories. Administration, Vaginal,Drug Administration, Vaginal,Instillation, Vaginal,Intravaginal Administration,Vaginal Drug Administration,Vaginal Administration,Administration, Vaginal Drug,Administrations, Intravaginal,Administrations, Vaginal,Administrations, Vaginal Drug,Drug Administrations, Vaginal,Instillations, Vaginal,Intravaginal Administrations,Vaginal Administrations,Vaginal Drug Administrations,Vaginal Instillation,Vaginal Instillations
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations

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