Løkeland Mette, Bjørge Tone, Iversen Ole-Erik, Akerkar Rupali, Bjørge Line
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.
Int J Epidemiol. 2017 Apr 1;46(2):643-651. doi: 10.1093/ije/dyw270.
Medical abortion with mifepristone and misoprostol was introduced in Norway in 1998, and since then there has been an almost complete change from predominantly surgical to medical abortions. We aimed to describe the medical abortion implementation process, and to compare characteristics of women obtaining medical and surgical abortion.
Information from all departments of obstetrics and gynaecology in Norway on the time of implementation of medical abortion and abortion procedures in use up to 12 weeks of gestation was assessed by surveys in 2008 and 2012. We also analysed data from the National Abortion Registry comprising 223 692 women requesting abortion up to 12 weeks of gestation during 1998-2013.
In 2012, all hospitals offered medical abortion, 84.4% offered medical abortion at 9-12 weeks of gestation and 92.1% offered home administration of misoprostol. The use of medical abortion increased from 5.9% of all abortions in 1998 to 82.1% in 2013. Compared with women having a surgical abortion, women obtaining medical abortion had higher odds for undergoing an abortion at 4-6 weeks (adjusted OR 2.33; 95% confidence interval 2.28-2.38). Waiting time between registered request for an abortion until termination was reduced from 11.3 days in 1998 to 7.3 days in 2013.
Norwegian women have gained access to more treatment modalities and simplified protocols for medical abortion. At the same time they obtained abortions at an earlier gestational age and the waiting time has been reduced.
米非司酮和米索前列醇药物流产于1998年在挪威引入，自那时起，流产方式从主要的手术流产几乎完全转变为药物流产。我们旨在描述药物流产的实施过程，并比较接受药物流产和手术流产的女性特征。
通过2008年和2012年的调查评估了挪威所有妇产科部门关于药物流产实施时间以及妊娠12周内使用的流产程序的信息。我们还分析了国家流产登记处的数据，该数据包括1998 - 2013年期间223692名妊娠12周内要求流产的女性。
2012年，所有医院都提供药物流产，84.4%的医院在妊娠9 - 12周时提供药物流产，92.1%的医院提供米索前列醇在家服用。药物流产的使用率从1998年所有流产的5.9%增加到2013年的82.1%。与接受手术流产的女性相比，接受药物流产的女性在4 - 6周进行流产的几率更高（调整后的比值比为2.33；95%置信区间为2.28 - 2.38）。从登记要求流产到终止妊娠的等待时间从1998年的11.3天减少到2013年的7.3天。
挪威女性获得了更多的治疗方式和简化的药物流产方案。与此同时，她们在更早的孕周进行流产，等待时间也缩短了。
