Ashok Premila W, Templeton Allan, Wagaarachchi Prabhath T, Flett Gillian M M
Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, UK.
BJOG. 2002 Nov;109(11):1281-9. doi: 10.1046/j.1471-0528.2002.02156.x.
To assess the outcome of a regimen of a reduced dose of mifepristone followed by one or two doses of vaginal misoprostol as a non-surgical method for termination of pregnancy.
Prospective observational study.
Aberdeen Royal Infirmary, Aberdeen, Scotland.
Women seeking abortion under the 1967 Abortion Act.
Factors influencing the outcome in a consecutive series of 4132 women undergoing early medical abortion in one Scottish teaching hospital since 1994.
Complete abortion rates following one or two doses of misoprostol. The effect of age, gestation, previous pregnancy and previous termination on complete abortion rates following the medical regimen.
Of the 4132 women, 95 (2.3%) aborted within 48 hours of mifepristone and a further 3942 (95.4%) achieved complete abortion following administration of one or two doses of misoprostol. Thus, the overall complete abortion rate was 97.7% (4037/4131). A total of 94 (2.3%) women required surgical intervention of whom 13 (0.3%) had a continuing pregnancy. Following change of the regimen to include the possibility of two doses of misoprostol the continuing pregnancy rates were significantly reduced (OR = 5.88) and gestation ceased to have an effect on overall efficacy. Women who had a previous abortion were more likely to have a failed medical abortion (OR = 2.09), while women with no previous termination, but a previous live birth were more likely to have a failed abortion (OR = 2.03).
Mifepristone in combination with one to two doses of vaginal misoprostol is an effective regimen for early medical abortion. The option of administering two doses of misoprostol significantly reduced the ongoing pregnancy rates and abolished the effect of gestation on overall efficacy. Previous termination was the strongest predictor of failed medical abortion.
评估采用降低剂量米非司酮方案，随后给予一剂或两剂阴道用米索前列醇作为非手术终止妊娠方法的效果。
前瞻性观察性研究。
苏格兰阿伯丁阿伯丁皇家医院。
依据1967年《堕胎法》寻求堕胎的女性。
自1994年起，在一家苏格兰教学医院对4132例接受早期药物流产的连续女性病例系列中影响结局的因素进行研究。
一剂或两剂米索前列醇后的完全流产率。年龄、孕周、既往妊娠及既往终止妊娠情况对药物流产方案后完全流产率的影响。
4132例女性中，95例（2.3%）在米非司酮用药后48小时内流产，另外3942例（95.4%）在给予一剂或两剂米索前列醇后实现完全流产。因此，总体完全流产率为97.7%（4037/4131）。共有94例（2.3%）女性需要手术干预，其中13例（0.3%）仍有持续妊娠。在改变方案以纳入给予两剂米索前列醇的可能性后，持续妊娠率显著降低（比值比=5.88），且孕周对总体疗效不再有影响。既往有过流产的女性药物流产失败的可能性更大（比值比=2.09），而既往未终止妊娠但有过活产的女性流产失败的可能性更大（比值比=2.03）。
米非司酮联合一剂或两剂阴道用米索前列醇是早期药物流产的有效方案。给予两剂米索前列醇的选择显著降低了持续妊娠率，并消除了孕周对总体疗效的影响。既往终止妊娠是药物流产失败的最强预测因素。
