Douthwaite Megan, Candelas Jose A, Reichwein Barbara, Eckhardt Carla, Ngo Thoai D, Domínguez Adriana
Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK.
Research and Evaluation, Marie Stopes Mexico, Mexico Distrito Federal, Mexico.
Int J Gynaecol Obstet. 2016 Jun;133(3):329-33. doi: 10.1016/j.ijgo.2015.11.009. Epub 2016 Feb 13.
To investigate whether starting progestin-only contraception immediately after mifepristone reduced the efficacy of early medical abortion with a mifepristone-misoprostol regimen.
A review of patient records from October 1, 2012 to March 31, 2013 from four Marie Stopes Mexico clinics in Mexico City was conducted. Patients were eligible for inclusion if they had undergone a medical abortion with mifepristone-misoprostol at no later than 63days of pregnancy, had a recorded outcome, and had either started progestin-only contraception immediately after mifepristone administration or had not started contraception. The primary outcome-successful induced abortion-was defined as the complete evacuation of uterine contents without the need for further intervention. A secondary outcome was the number of induced abortions completed without the need for manual vacuum aspiration.
Records from 2204 patients were included; 448 (20.3%) patients had started progestin-only contraception, and 1756 (79.7%) had not. Patients not taking progestin-only contraception were significantly more likely to be primigravidas and nulliparous. Medical abortion success did not vary between the two groups; 1890 (85.8%) were successful and 2085 (94.6%) were completed without the need for manual vacuum aspiration. Different methods of progestin-only contraception did not affect medical abortion outcomes.
Beginning progestin-only contraception immediately following mifepristone for early medical abortion was not associated with reduced medical abortion effectiveness.
探讨米非司酮后立即开始单纯孕激素避孕是否会降低米非司酮 - 米索前列醇方案早期药物流产的疗效。
对2012年10月1日至2013年3月31日墨西哥城四家玛丽斯特普斯墨西哥诊所的患者记录进行回顾。符合纳入标准的患者为妊娠不超过63天接受米非司酮 - 米索前列醇药物流产、有记录结局且在服用米非司酮后立即开始单纯孕激素避孕或未开始避孕者。主要结局——成功诱导流产——定义为子宫内容物完全排出且无需进一步干预。次要结局是无需人工负压吸引完成的诱导流产数量。
纳入2204例患者的记录；448例（20.3%）患者开始单纯孕激素避孕，1756例（79.7%）未开始。未服用单纯孕激素避孕的患者初产妇和未生育者明显更多。两组间药物流产成功率无差异；1890例（85.8%）成功，2085例（94.6%）无需人工负压吸引完成。不同的单纯孕激素避孕方法不影响药物流产结局。
米非司酮后立即开始单纯孕激素避孕用于早期药物流产与药物流产效果降低无关。
