Métodos quirúrgicos versus farmacológicos en la interrupción del embarazo durante el primer trimestre. Revisión Sistemática

Abstract

Background: Abortion is defined as the expulsion or extraction of a fetus before 22 weeks of gestation or weighing less than 500 grams. It is classified as accidental, induced, or spontaneous, often accompanied by personal and social challenges. General objective: To compare the use of surgical versus pharmacological methods for first-trimester abortion. Specific objectives: To identify the surgical and pharmacological methods used in abortion. To establish a hierarchy of available methods based on their effectiveness, safety, and complication profiles. To assess the quality of evidence of the selected studies for the review. Method: An electronic search was conducted, including clinical trials from the PubMed, Scopus, SciELO, Taylor & Francis, and Web of Science databases. Each article was reviewed and analyzed. Results: A systematic review was performed comparing complete expulsion with pharmacological methods versus surgical methods. The response of the favored method was observed, considering different risk-benefit measures across intervals and heterogeneity. Conclusions: For complete expulsion of fetuses in first-trimester pregnancies, the safest method involves using sublingual misoprostol with intrauterine aspiration, which can be a safe and effective option with fewer short- and long-term complications. Keywords: abortion, pregnancy, surgical method, pharmacological method, first trimester