Briozzo L, Vidiella G, Rodríguez F, Gorgoroso M, Faúndes A, Pons J E
Department of Obstetrics and Gynecology, School of Medicine, University of the Republic, Montevideo, Uruguay.
Int J Gynaecol Obstet. 2006 Nov;95(2):221-6. doi: 10.1016/j.ijgo.2006.07.013. Epub 2006 Sep 27.
Worldwide, 13% of maternal deaths are caused by complications of spontaneous or induced abortion, 29% in Uruguay and nearly half (48%) in the Pereira Rossell Hospital.
This paper describes a risk reduction strategy for unsafe abortions in Montevideo, Uruguay, where over one-fourth of maternal deaths are caused by unsafe abortion.
Although abortion is not legal in Uruguay, women desiring abortions can be counseled before and immediately after to reduce the risk of injury. Women contemplating abortion were invited to attend a "before-abortion" and an "after-abortion" visit at a reproductive health polyclinic. At the "before-abortion" visit, gestational age, condition of the fetus and pathologies were diagnosed and the risks associated with the use of different abortion methods (based on the best available scientific evidence) were described. The "after-abortion" visit allowed for checking for possible complications and offering contraception.
From March 2004 through June 2005, 675 women attended the "before-abortion" and 495 the "after-abortion" visit, the number increasing over time. Some women (3.5%) decided not to abort, others were either not pregnant, the fetus/embryo was dead or the woman had a condition that permitted legal termination of pregnancy in the hospital (7.5%). Most women, however, aborted. All women used vaginal misoprostol in the doses recommended in the medical literature. There were no serious complications (one mild infection and two hemorrhages not requiring transfusion).
The strategy is effective in reducing unsafe abortions and their health consequences.
在全球范围内，13%的孕产妇死亡是由自然流产或人工流产并发症导致的，在乌拉圭这一比例为29%，而在佩雷拉·罗塞尔医院这一比例接近一半（48%）。
本文描述了乌拉圭蒙得维的亚减少不安全堕胎的风险降低策略，在该地超过四分之一的孕产妇死亡是由不安全堕胎导致的。
尽管在乌拉圭堕胎不合法，但对于希望堕胎的女性，可以在堕胎前后提供咨询以降低受伤风险。考虑堕胎的女性被邀请到一家生殖健康综合诊所进行“堕胎前”和“堕胎后”检查。在“堕胎前”检查中，诊断孕周、胎儿状况和病理情况，并描述使用不同堕胎方法（基于现有最佳科学证据）的相关风险。“堕胎后”检查用于检查是否有可能的并发症并提供避孕措施。
从2004年3月到2005年6月，675名女性参加了“堕胎前”检查，495名女性参加了“堕胎后”检查，人数随时间增加。一些女性（3.5%）决定不堕胎，其他女性要么未怀孕，胎儿/胚胎已死亡，要么女性患有允许在医院合法终止妊娠的疾病（7.5%）。然而，大多数女性还是选择了堕胎。所有女性都按照医学文献推荐的剂量使用了阴道米索前列醇。没有出现严重并发症（1例轻度感染和2例无需输血的出血）。
该策略在减少不安全堕胎及其对健康的影响方面是有效的。
