Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Acta Obstet Gynecol Scand. 2014 Jul;93(7):647-53. doi: 10.1111/aogs.12398. Epub 2014 May 23.
To evaluate the acceptability and efficacy of medical abortion at home up to 63 days' gestation without limits on travel distance to a registered institution.
Observational prospective study.
Haukeland University Hospital between May 2006 and May 2009.
A total of 1018 women requesting abortion before 63 days' gestation who chose medical termination with mifepristone and home administration of misoprostol.
The women took 200 mg mifepristone under nurse supervision and self-administered 800 μg misoprostol vaginally 36-48 h later at home. All were contacted by phone for follow-up and assessment of bleeding, pain and acceptability.
Evacuation rate, pain, bleeding, acceptability, influence of distance on treatment.
Median gestational age was 50 (range 35-63) days and 70 (7.1%) of the women lived more than 60 min travel from the clinic. The rate of completed abortion was 93.6% and surgical evacuation was performed in 50 (4.9%) cases. Two women requested treatment on the day of misoprostol use. Moderate to strong pain was experienced by 68.4%, and 74.7% reported moderate to heavy bleeding. Parous women experienced less pain than nulliparous women (odds ratio 0.27; 95% confidence interval 0.19-0.34). In all, 95.1% of the women were satisfied with staying at home. Travel distance did not influence treatment outcome variables.
In our experience, home administration of misoprostol is an effective and acceptable method for abortion up to 63 days of gestation and women should be eligible for this treatment option regardless of their travel distance from hospital.
评估在距离注册机构无限制的情况下，在家中进行至 63 天妊娠的药物流产的可接受性和疗效。
观察性前瞻性研究。
豪克兰大学医院，2006 年 5 月至 2009 年 5 月。
共有 1018 名要求在 63 天妊娠前进行流产的妇女，她们选择米非司酮药物流产，并在家中自行使用米索前列醇。
妇女在护士监督下服用 200mg 米非司酮，36-48 小时后在家中自行阴道内给予 800μg 米索前列醇。所有妇女均通过电话进行随访，评估出血、疼痛和可接受性。
流产率、疼痛、出血、可接受性、距离对治疗的影响。
中位妊娠年龄为 50 天（范围 35-63 天），70 名（7.1%）妇女距离诊所超过 60 分钟车程。完全流产率为 93.6%，50 例（4.9%）需要手术清宫。2 名妇女在使用米索前列醇当天要求治疗。68.4%的妇女经历中度至强烈疼痛，74.7%的妇女报告中度至重度出血。经产妇的疼痛程度低于初产妇（优势比 0.27；95%置信区间 0.19-0.34）。总的来说，95.1%的妇女对在家治疗感到满意。旅行距离未影响治疗结局变量。
根据我们的经验，在家中使用米索前列醇是一种有效且可接受的 63 天妊娠内流产方法，无论妇女距离医院的旅行距离如何，都应具备这种治疗选择的资格。
