Akin Ayse, Kocoglu Gonca Oktay, Akin Levent
Department of Public Health, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Reprod Health Matters. 2005 Nov;13(26):101-9. doi: 10.1016/S0968-8080(05)26207-9.
In Turkey, there is an unmet need for induced abortion services provided by the public health services, especially in rural and semi-urban areas. The objective of this clinical study was to show that early medical abortion could be introduced safely in Turkey to improve women's access to services. In the study, women aged 18-49 up to 56 days of pregnancy were offered a choice between medical abortion with 200 mg mifepristone followed by 400 mcg oral misoprostol and MVA with local anaesthesia. 209 chose medical and 149 surgical abortion. Data from an additional 112 women were collected to obtain a similar number of surgical abortion cases. Women's preference for and satisfaction with the chosen method, side effects and complications up to the 14-day follow-up visit were recorded. 75% of women who chose medical abortion opted for home use of misoprostol. Pain with medical abortion on average lasted 3.6 +/- 3.0 days and with surgical abortion 3.7 +/- 2.9 days. 90% of women who had medical abortion said they would prefer it again compared to 70% of those having surgical abortion. There were 1.4% ongoing pregnancies in the medical abortion group and none in the surgical group. Provider training and familiarity with medical abortion are crucial. The high incomplete abortion rate indicates that the dose and regimen of misoprostol should be reconsidered. The findings support the introduction of early medical abortion in Turkey.
在土耳其，公共卫生服务提供的人工流产服务存在未被满足的需求，尤其是在农村和半城市地区。这项临床研究的目的是表明，在土耳其可以安全地引入早期药物流产，以改善妇女获得服务的机会。在该研究中，为怀孕56天以内、年龄在18至49岁的女性提供了两种选择：一种是服用200毫克米非司酮后再口服400微克米索前列醇进行药物流产，另一种是在局部麻醉下进行手动真空吸引术（MVA）。209名女性选择了药物流产，149名选择了手术流产。另外收集了112名女性的数据，以获得数量相近的手术流产病例。记录了女性对所选方法的偏好和满意度、副作用以及直至14天随访期的并发症情况。选择药物流产的女性中有75%选择在家自行使用米索前列醇。药物流产的疼痛平均持续3.6±3.0天，手术流产的疼痛平均持续3.7±2.9天。90%接受药物流产的女性表示她们会再次选择药物流产，而接受手术流产的女性中这一比例为70%。药物流产组有1.4%的女性持续妊娠，手术组则没有。提供者的培训以及对药物流产的熟悉程度至关重要。较高的不完全流产率表明米索前列醇的剂量和用药方案应重新考虑。这些研究结果支持在土耳其引入早期药物流产。
