DePiñeres Teresa, Baum Sarah, Grossman Daniel
Fundación Oriéntame, Bogotá, Colombia.
Ibis Reproductive Health, Oakland, CA, USA.
Contraception. 2014 Sep;90(3):242-8. doi: 10.1016/j.contraception.2014.05.002. Epub 2014 May 14.
OBJECTIVE(S): Since partial decriminalization of abortion in Colombia, Oriéntame has provided legal abortion services through 15 weeks gestation in an outpatient primary care setting. We sought to document the safety and acceptability of the second trimester compared to the first-trimester surgical abortion in this setting.
This was a prospective cohort study using a consecutive sample of 100 women undergoing surgical first-trimester abortion (11 weeks 6 days gestational age or less) and 200 women undergoing second-trimester abortion (12 weeks 0 days-15 weeks 0 days) over a 5-month period in 2012. After obtaining informed consent, a trained interviewer collected demographic and clinical information from direct observation and the patient's clinical chart. The interviewer asked questions after the procedure regarding satisfaction with the procedure, physical pain and emotional discomfort. Fifteen days later, the interviewer assessed satisfaction with the procedure and any delayed complications.
There were no major complications and seven minor complications. Average measured blood loss was 37.87 mL in the first trimester and 109 mL in the second trimester (p<.001). Following the procedure, more second-trimester patients reported being very satisfied (81% vs. 94%, p=.006). Satisfaction was similar between groups at follow-up. There were no differences in reported emotional discomfort after the procedure or at follow-up, with the majority reporting no emotional discomfort. The majority of women (99%) stated that they would recommend the clinic to a friend or family member.
Second-trimester surgical abortion in an outpatient primary care setting in Colombia can be provided safely, and satisfaction with these services is high.
This is one of the first studies from Latin America, a region with a high proportion of maternal mortality due to unsafe abortion, which documents the safety and acceptability of surgical abortion in an outpatient primary care setting. Findings could support increased access to safe abortion services, particularly in the second trimester.
自从哥伦比亚部分堕胎合法化以来，Oriéntame在门诊初级保健机构为妊娠15周以内的孕妇提供合法堕胎服务。我们试图记录在这种情况下，与孕早期手术堕胎相比，孕中期堕胎的安全性和可接受性。
这是一项前瞻性队列研究，在2012年的5个月期间，连续抽取了100名接受孕早期手术堕胎（妊娠11周6天或更短）的妇女和200名接受孕中期堕胎（12周0天至15周0天）的妇女作为样本。在获得知情同意后，一名经过培训的访谈者通过直接观察和患者的临床病历收集人口统计学和临床信息。访谈者在手术后询问有关对手术的满意度、身体疼痛和情绪不适的问题。十五天后，访谈者评估对手术的满意度以及任何延迟出现的并发症。
没有重大并发症，有七例轻微并发症。孕早期平均出血量为37.87毫升，孕中期为109毫升（p<0.001）。手术后，更多的孕中期患者表示非常满意（81%对94%，p=0.006）。随访时两组之间的满意度相似。手术后或随访时报告的情绪不适没有差异，大多数人表示没有情绪不适。大多数妇女（99%）表示她们会向朋友或家人推荐该诊所。
在哥伦比亚的门诊初级保健机构进行孕中期手术堕胎是安全的，并且对这些服务的满意度很高。
这是拉丁美洲的首批研究之一，该地区因不安全堕胎导致孕产妇死亡率很高，这项研究记录了门诊初级保健机构手术堕胎的安全性和可接受性。研究结果可能有助于增加获得安全堕胎服务的机会，特别是在孕中期。
