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左炔诺孕酮紧急避孕的作用机制。

Mechanism of action of levonorgestrel emergency contraception.

作者信息

Kahlenborn Chris, Peck Rebecca, Severs Walter B

机构信息

The Polycarp Research Institute, Enola, PA, USA.

Florida State University College of Medicine, FL, USA.

出版信息

Linacre Q. 2015 Feb;82(1):18-33. doi: 10.1179/2050854914Y.0000000026.

Abstract

There has been much debate regarding levonorgestrel emergency contraception's (LNG-EC's) method of action since 1999 when the Food and Drug Administration first approved its use. Proponents of LNG-EC have argued that they have moral certitude that LNG-EC works via a non-abortifacient mechanism of action, and claim that all the major scientific and medical data consistently support this hypothesis. However, newer medical data serve to undermine the consistency of the non-abortifacient hypothesis and instead support the hypothesis that preovulatory administration of LNG-EC has significant potential to work via abortion. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room protocols. In the future, technology such as the use of early pregnancy factor may have the potential to quantify how frequently preovulatory LNG-EC works via abortion. Lay Summary: How Plan B (levonorgestrel emergency contraception) works has been vigorously debated ever since the Food and Drug Administration approved it in 1999. Many doctors and researchers claim that it has either no-or at most-an extremely small chance of working via abortion. However, the latest scientific and medical evidence now demonstrates that levonorgestrel emergency contraception theoretically works via abortion quite often. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room rape protocols.

摘要

自1999年美国食品药品监督管理局首次批准左炔诺孕酮紧急避孕法(LNG-EC)的使用以来,关于其作用机制一直存在诸多争议。LNG-EC的支持者认为,他们坚信LNG-EC通过非堕胎机制发挥作用,并声称所有主要的科学和医学数据都一致支持这一假设。然而,新的医学数据却削弱了非堕胎假设的一致性,转而支持了这样一种假设,即排卵前服用LNG-EC有很大可能通过堕胎起作用。这些新数据对医务人员、患者以及天主教和非天主教的急诊室诊疗规范都有重要影响。未来,诸如使用早期妊娠因子等技术可能有潜力量化排卵前LNG-EC通过堕胎起作用的频率。通俗总结:自1999年美国食品药品监督管理局批准“紧急避孕药(Plan B,左炔诺孕酮紧急避孕法)”以来,其作用方式一直备受激烈争论。许多医生和研究人员称,它要么不会——或者至多只有极小的可能性——通过堕胎起作用。然而,最新的科学和医学证据如今表明,左炔诺孕酮紧急避孕法理论上常常通过堕胎起作用。这些新数据的影响对医务人员、患者以及天主教和非天主教的急诊室强奸诊疗规范都有重要意义。

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