Van Look Paul F A, Cottingham Jane C
Department of Reproductive Health and Research, World Health Organization, 1211 Geneva 27, Switzerland.
Best Pract Res Clin Obstet Gynaecol. 2002 Apr;16(2):205-20. doi: 10.1053/beog.2002.0271.
An estimated 60 000-70 000 women die annually from complications of unsafe abortion and hundreds of thousands more suffer long-term consequences which include chronic pelvic pain and infertility. The reasons for the continuing high incidence of unwanted pregnancy leading to unsafe abortion include lack of access to, or misuse of and misinformation about, effective contraceptive methods, coerced sex which prohibits women from protecting themselves, and contraceptive failure. Unsafe abortion is closely associated with restrictive legal environments and administrative and policy barriers hampering access to existing services. Vacuum aspiration and medical methods combining mifepristone and a prostaglandin for early abortion are simple and safe. For second trimester abortion, the main choices are repeat doses of prostaglandin with or without prior mifepristone, and dilatation and evacuation by experienced providers. Strategies for preventing unsafe abortion include: upgrading providers' skills; further development of medical methods for pregnancy termination and their introduction into national programmes; improving the quality of contraceptive and abortion services; and improving partner communication.
据估计，每年有6万至7万名妇女死于不安全堕胎并发症，还有数十万人遭受长期后果，包括慢性盆腔疼痛和不孕。导致不安全堕胎的意外怀孕持续高发的原因包括：无法获得有效避孕方法、对有效避孕方法的误用和错误信息、强迫性行为使妇女无法保护自己以及避孕失败。不安全堕胎与限制法律环境以及阻碍获得现有服务的行政和政策障碍密切相关。真空吸引术以及将米非司酮和前列腺素联合用于早期堕胎的药物方法简单且安全。对于中期堕胎，主要选择是重复使用前列腺素（有或没有事先使用米非司酮），以及由经验丰富的医疗人员进行扩张和清宫术。预防不安全堕胎的策略包括：提高医疗人员的技能；进一步开发终止妊娠的药物方法并将其纳入国家计划；提高避孕和堕胎服务的质量；以及改善伴侣间的沟通。
