Center of Reproductive Health, icddr,b, Dhaka, Bangladesh.
Int Perspect Sex Reprod Health. 2013 Jun;39(2):79-87. doi: 10.1363/3907913.
Annually, more than 700,000 women turn to menstrual regulation, or uterine evacuation with vacuum aspiration; many more resort to unsafe abortion. Using pills for the evacuation of the uterus could increase women's access to safe menstrual regulation services and reduce the high levels of abortion- and menstrual regulation- related morbidity in Bangladesh.
At 10 facilities in Bangladesh, 651 consenting women who were seeking menstrual regulation services and who were 63 days or less past their last menstrual period received 200 mg of mifepristone followed 24 hours later by 800 mcg of buccal misoprostol, administered either at home or in the clinic. Prospective data were collected to determine women's experience and satisfaction with the procedure, menstrual regulation outcome, and the human and physical resources required for providing the method. Focus group discussions were conducted with a purposively sampled group of service providers at each site to understand their attitudes about the introduction of menstrual regulation with medication.
The majority of women (93%) with known menstrual regulation outcomes evacuated the uterus without surgical intervention. Overall, most women (92%) were satisfied with use of pills for their menstrual regulation. Providers faced initial challenges and concerns, particularly related to the additional counseling requirements and lack of control over the final outcome, but became more confident after successful use of the medication regimen.
Mifepristone-misoprostol can be safely offered within existing menstrual regulation services in urban and periurban areas in Bangladesh and is highly acceptable to women. Providers' initial concerns diminish with increased experience with the method.
每年有超过 70 万名妇女寻求经期调节，即通过真空抽吸排空子宫；更多的人则诉诸不安全的堕胎。使用药物排空子宫可以增加妇女获得安全的经期调节服务的机会，并降低孟加拉国因堕胎和经期调节而导致的高发病率。
在孟加拉国的 10 个设施中，有 651 名同意接受经期调节服务的妇女，她们的末次月经已经过去 63 天或更短时间，她们接受了 200 毫克米非司酮，24 小时后再接受 800 微克口腔米索前列醇，这些药物可以在家中或诊所使用。前瞻性收集数据，以确定妇女对该程序的体验和满意度、经期调节结果，以及提供该方法所需的人力和物力资源。在每个地点，与服务提供者进行了有针对性的焦点小组讨论，以了解他们对药物调节经期的引入的态度。
大多数（93%）已知经期调节结果的妇女无需手术干预即可排空子宫。总体而言，大多数妇女（92%）对使用药物调节经期表示满意。提供者最初面临挑战和担忧，特别是与额外的咨询要求以及对最终结果缺乏控制有关，但在成功使用药物方案后，他们变得更加有信心。
米非司酮-米索前列醇可以在孟加拉国的城市和城郊地区现有的经期调节服务中安全提供，并且深受妇女欢迎。提供者最初的担忧随着对该方法经验的增加而减少。
