2014 年孟加拉国的经期调节程序和人工流产发生率。

The Incidence of Menstrual Regulation Procedures and Abortion in Bangladesh, 2014.

机构信息

Guttmacher Institute.

Association for Prevention of Septic Abortion.

出版信息

Int Perspect Sex Reprod Health. 2017 Mar 21;43(1):1-11. doi: 10.1363/43e2417.

DOI:10.1363/43e2417

PMID:28930621

Abstract

CONTEXT

Menstrual regulation (MR) has been part of the Bangladesh family planning program since 1979. However, clandestine abortion remains a serious health problem in Bangladesh, and anecdotal reports indicate that clandestine use of misoprostol has increased since the most recent estimates (for 2010). Because of this, it is important to assess changes in the use of MR services and the incidence of clandestine abortion since 2010.

METHODS

A survey of a nationally representative sample of 829 health facilities that provide MR or postabortion care services and a survey of 322 professionals knowledgeable about these services were conducted in 2014. Direct and indirect methods were applied to calculate the incidence of MR and induced abortion.

RESULTS

In 2014, an estimated 1,194,000 induced abortions were performed in Bangladesh (29 per 1,000 women aged 15-49), and 257,000 women were treated for complications of such abortions (a rate of 6 per 1,000 women aged 15-49). Among women with complications, the proportion presenting with hemorrhage increased significantly, from 27% to 48%. An estimated 430,000 MR procedures (using MVA or medication) were performed in health facilities nationwide, a decline of about 40% in the MR rate-from 17 to 10 per 1,000 women aged 15-49-from 2010 to 2014.

CONCLUSIONS

Given declines in MR provision, more attention needs to be paid to building capacity, including hiring and training more providers of MR. Harm-reduction approaches should be pursued to increase the safety of clandestine use of misoprostol in Bangladesh.

摘要

背景

自 1979 年以来，孟加拉国的计划生育项目就包括了经期调控（MR）。然而，秘密堕胎仍然是孟加拉国一个严重的健康问题，并且传闻报告表明，自最近一次（2010 年）估计以来，秘密使用米索前列醇的情况有所增加。因此，评估自 2010 年以来 MR 服务的使用变化和秘密堕胎的发生率非常重要。

方法

2014 年对提供 MR 或堕胎后护理服务的全国 829 个卫生机构进行了一项具有代表性的样本调查，并对 322 名了解这些服务的专业人员进行了调查。采用直接和间接方法来计算 MR 和人工流产的发生率。

结果

2014 年，孟加拉国估计有 1194000 例人工流产（每 1000 名 15-49 岁妇女中有 29 例），257000 名妇女因此类堕胎并发症接受治疗（每 1000 名 15-49 岁妇女中有 6 例）。在有并发症的妇女中，出血的比例从 27%显著增加到 48%。全国卫生机构共进行了约 430000 例 MR 手术（使用 MVA 或药物），MR 率从 2010 年的每 1000 名 15-49 岁妇女 17 例下降到 2014 年的 10 例，下降了约 40%。