Factores asociados a la eficacia del manejo farmacológico del aborto en el primer trimestre en pacientes atendidas en el Hospital General Martín Icaza, Babahoyo, octubre 2024 - mayo 2025.

Abstract

Objective: To establish the factors associated with the effectiveness of pharmacological management of abortion in the first trimester in patients attended at the Martin Icaza General Hospital, Babahoyo, from October 2024 to May 2025. Material and Method: Inductive - quantitative method. Abortion is an increasingly common condition, and pharmacological management has become the first-line option to avoid invasive and painful procedures for women. This management is characterized by the use of prostaglandins, which impact the smooth muscle of the uterus. Thus, it allows for outpatient management without subjecting the woman to an invasive and traumatic process. Results: The effectiveness of pharmacological management of abortion is associated with several factors. Among obstetric factors, parity stands out, with 17% primigravidas and 80% multiparas, who have a history of vaginal deliveries (41%), cesarean sections (54%), and abortions (47%). The gestational age at which these abortions mostly occurred was under 8 weeks (61%), which also corresponds to the age where the treatment had the best results. The success of pharmacological treatment was 77%, mainly due to a single-dose regimen of 600mcg (47%); patients requiring a surgical procedure represented 23%, with uterine curettage being the most commonly used practice (15%). Conclusions: Pharmacological management of abortion with Misoprostol is safe and effective. A standardized dosage for our setting is established, and the associated routes of administration allow for more successful outcomes, enabling clinicians to select patients for individualized treatment.Objective: To establish the factors associated with the effectiveness of pharmacological management of abortion in the first trimester in patients attended at the Martin Icaza General Hospital, Babahoyo, from October 2024 to May 2025. Material and Method: Inductive - quantitative method. Abortion is an increasingly common condition, and pharmacological management has become the first-line option to avoid invasive and painful procedures for women. This management is characterized by the use of prostaglandins, which impact the smooth muscle of the uterus. Thus, it allows for outpatient management without subjecting the woman to an invasive and traumatic process. Results: The effectiveness of pharmacological management of abortion is associated with several factors. Among obstetric factors, parity stands out, with 17% primigravidas and 80% multiparas, who have a history of vaginal deliveries (41%), cesarean sections (54%), and abortions (47%). The gestational age at which these abortions mostly occurred was under 8 weeks (61%), which also corresponds to the age where the treatment had the best results. The success of pharmacological treatment was 77%, mainly due to a single-dose regimen of 600mcg (47%); patients requiring a surgical procedure represented 23%, with uterine curettage being the most commonly used practice (15%). Conclusions: Pharmacological management of abortion with Misoprostol is safe and effective. A standardized dosage for our setting is established, and the associated routes of administration allow for more successful outcomes, enabling clinicians to select patients for individualized treatment.Objetivo: Establecer los factores asociados a la eficacia del manejo farmacológico del aborto en el primer trimestre en las pacientes atendidas en el Hospital General Martin Icaza, Babahoyo, Octubre 2024 - Mayo 2025. Material y método: Método inductivo- cuantitativo. El aborto es una entidad más frecuente cada vez y el manejo farmacológico se ha convertido en la opción de primera línea para evitar procedimientos invasivos y dolorosos para la mujer. Este manejo se caracteriza por utilizar prostaglandinas, mismas que tienen impacto sobre el musculo liso del útero. De esta manera se puede obtener un manejo ambulatorio sin tener que someter a la mujer a un proceso invasivo y traumático. Resultados: La eficacia del manejo farmacológico del aborto está asociado a varios factores, entre los factores obstétricos se destaca la paridad, primigestas 17% y multíparas 80%, quienes presentan antecedentes como partos por vía vaginal (41%), cesáreas (54%), y abortos (47%); la edad gestacional donde aconteció mayoritariamente estos abortos fue menor a las 8 semanas (61%), y a su vez es la edad donde el tratamiento tuvo mejores resultados. El éxito del tratamiento farmacológico fue del 77%, principalmente por el esquema de una dosis única de 600mcg (47%); las pacientes que requirieron un procedimiento quirúrgico constituye al 23%, llama la atención que el legrado uterino instrumentado sigue siendo la práctica más empleada (15%). Conclusiones: El manejo farmacológico del aborto con Misoprostol es seguro y efectivo, se estandariza una dosificación para nuestro medio y las vías que se asocian con mayor o menor éxito que permitan al clínico la selección individualizada de las pacientes