Cavet Sandra, Fiala Christian, Scemama Agathe, Partouche Henri
a Department of General Medicine, Faculty of Medicine , Paris Descartes University, Sorbonne Paris Cité , Paris , France.
b Gynmed Clinic , Vienna , Austria.
Eur J Contracept Reprod Health Care. 2017 Jun;22(3):207-211. doi: 10.1080/13625187.2017.1315092. Epub 2017 Apr 27.
Although medical abortion with home use of misoprostol has been shown to be safe and acceptable, there are few data about the experience of pain during the procedure. The aims of this study were to assess the intensity of pain associated with home use of misoprostol for medical abortion and to identify variables associated with severe pain.
This was an observational study using an anonymous web-based questionnaire in patients having a medical abortion at home in France between 1 December 2013 and 30 April 2014.
The questionnaire was completed by 232 women and the results of 193 were retained for analysis. The average pain score was 5.6 on a 10 point scale. A pain score ≥6 was rated as severe and was reported by 105 patients (54%). Nulliparity (odds ratio [OR] 4.10; 95% confidence interval [CI] 2.04, 8.22; p < .0001), lack of choice regarding the method of abortion (OR 2.32; 95% CI 1.13, 4.78; p = .0218) and lack of information about the level of pain associated with the procedure (OR 3.27; 95% CI 1.09, 9.74; p = .0334) were significantly correlated with severe pain. Analgesic prescriptions were very heterogeneous.
Pain remains the main side effect of medical abortion. More studies are needed on pain assessment and the effectiveness of analgesic treatments in women using misoprostol at home for medical abortion, in order to improve their care and improve evidence-based guidelines.
尽管已证明在家自行使用米索前列醇进行药物流产是安全且可接受的，但关于流产过程中的疼痛体验的数据却很少。本研究的目的是评估在家自行使用米索前列醇进行药物流产时的疼痛强度，并确定与剧痛相关的变量。
这是一项观察性研究，采用匿名网络问卷对2013年12月1日至2014年4月30日期间在法国在家进行药物流产的患者进行调查。
232名女性完成了问卷，193人的结果被保留用于分析。疼痛平均评分为5.6分（满分10分）。疼痛评分≥6分被评为剧痛，105名患者（54%）报告有剧痛。未生育（比值比[OR]4.10；95%置信区间[CI]2.04，8.22；p＜0.0001）、对流产方法没有选择余地（OR 2.32；95%CI 1.13，4.78；p = 0.0218）以及对与该过程相关的疼痛程度缺乏了解（OR 3.27；95%CI 1.09，9.74；p = 0.0334）与剧痛显著相关。镇痛处方非常多样化。
疼痛仍然是药物流产的主要副作用。需要对在家使用米索前列醇进行药物流产的女性的疼痛评估和镇痛治疗效果进行更多研究，以改善她们的护理并完善循证指南。
