Kapamadzija Aleksandra, Vukelić Jelka, Bjelica Artur, Kopitović Vesna
Klinika za ginekologiju i akuserstvo, Klinicki centar Vojvodine, Novi Sad.
Med Pregl. 2010 Jan-Feb;63(1-2):63-7. doi: 10.2298/mpns1002063k.
Modern methods of medically induced abortions are being used in many countries all over the world. These methods are safe and effective when used in an appropriate way.
The most widely used regimens for drug induced abortions include antiprogestogen mifepriston followed by administration of a synthetic prostaglandin analogue--gemeprost vaginally or misoprostol orally or vaginally. When used for abortions up to 9 and 7 weeks of pregnancy, this method has efficacy up to 98%. The regimen between 9 and 12 completed weeks is still under investigation. Methods for medical abortion after 12 completed weeks since last menstrual period include several regimens and medications--combination of mifepriston and repeated doses of misoprostol, misoprostol or gemeprost alone, methotrexate, synthetic prostaglandin analogues, oxytocin and some others.
MEDICAL ABORTIONS AT OUR DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, NOVI SAD, CLINICAL CENTER VOJVODINE, SERBIA: Medical abortions in the second trimester were introduced at our Department of Obstetrics and Gynecology Novi Sad, Serbia, in early 1980s using prostaglandin analogues. This method was improved in year 2000 introducing two dinoprostone gels intracervically/extraaminally instead of just one, for cervical preparation before intramuscular application of carboprost thrometamine, which led to significantly shorter abortion interval. During the years 2003/2004 we took part successfully in one of the multicentric WHO projects for investigating new regimens on early medical abortions with mifepriston and misoprostol.
Modern methods of medical abortions are safe and effective for termination of unwanted pregnancies in the first and second trimester.
现代药物流产方法在世界许多国家都有应用。这些方法在恰当使用时是安全有效的。
药物流产最常用的方案包括抗孕激素米非司酮，随后经阴道给予合成前列腺素类似物吉美前列素，或口服或经阴道给予米索前列醇。用于妊娠9周及7周以内的流产时，该方法的有效率高达98%。妊娠9至12周完整孕期的流产方案仍在研究中。自末次月经起12周完整孕期后的药物流产方法包括几种方案和药物——米非司酮与重复剂量米索前列醇联合使用、单独使用米索前列醇或吉美前列素、甲氨蝶呤、合成前列腺素类似物、缩宫素等。
20世纪80年代初，塞尔维亚诺维萨德妇产科开始使用前列腺素类似物进行中期药物流产。2000年对该方法进行了改进，在肌肉注射卡前列素氨丁三醇前，宫颈内/羊膜外使用两种地诺前列酮凝胶而非仅一种，用于宫颈准备，这显著缩短了流产间隔时间。在2003/2004年期间，我们成功参与了世界卫生组织的一项多中心项目，该项目旨在研究米非司酮和米索前列醇早期药物流产的新方案。
现代药物流产方法对于终止孕早期和孕中期意外妊娠是安全有效的。
