Tam Wing Hung, Tsui Michelle Hang Yuet, Lok Ingrid Hung, Yip Shing-Kai, Yuen Pong Mo, Chung Tony Kwok Hung
Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hum Reprod. 2005 Dec;20(12):3355-9. doi: 10.1093/humrep/dei257. Epub 2005 Aug 11.
When compared with the conventional surgical evacuation for the treatment of miscarriage, medical evacuation has been largely accepted as an effective and safe management. However, there is a lack of data on the long-term reproductive outcome of these two treatment modalities, which is crucial in patient counselling. The current study evaluates and compares the long-term fertility and pregnancy outcome following these two treatments.
A cohort of 604 women enrolled in a previous randomized controlled trial comparing medical and surgical evacuation for miscarriage were followed up prospectively by telephone interview at a median of 6 (range 4-9) years using a structured questionnaire.
A total of 423 women were contacted and four declined to participate (response rate 69.4%). Of these, 261 women (131 medical and 130 surgical evacuations) had attempted to become pregnant since the miscarriage. There were no differences in their baseline characteristics including age, reproductive and contraceptive history. The natural conception rates were the same (97.7%, P = 0.99) and the cumulative pregnancy rates were similar between groups, being 60 and 80% at 12 and 24 months respectively. The median time-to-pregnancy was 8 months in both groups (P = 0.97) and the subsequent live birth rates (85.2 versus 88.2%, P = 0.72) resulting from the immediate pregnancy following previous treatment were similar.
The long-term conception rate and pregnancy outcome are not different following medical or surgical evacuation for miscarriage. Women should be reassured that their long-term fertility potential will not be compromised after medical treatment.
与传统手术清宫治疗流产相比，药物流产已被广泛认为是一种有效且安全的治疗方法。然而，关于这两种治疗方式的长期生殖结局的数据尚缺乏，而这在患者咨询中至关重要。本研究评估并比较了这两种治疗后的长期生育能力和妊娠结局。
对604名参与过比较药物流产和手术清宫治疗流产的随机对照试验的女性进行队列研究，采用结构化问卷通过电话随访进行前瞻性研究，随访时间中位数为6年（范围4 - 9年）。
共联系到423名女性，4人拒绝参与（应答率69.4%）。其中，261名女性（131例药物流产和130例手术清宫）自流产后尝试怀孕。她们的基线特征包括年龄、生殖和避孕史均无差异。自然受孕率相同（97.7%，P = 0.99），两组的累积妊娠率相似，12个月和24个月时分别为60%和80%。两组的平均受孕时间均为8个月（P = 0.97），先前治疗后立即怀孕的后续活产率相似（85.2%对88.2%，P = 0.72）。
药物流产或手术清宫治疗流产后的长期受孕率和妊娠结局无差异。应让女性放心，药物治疗后她们的长期生育潜力不会受到影响。
