Planned Parenthood Global, Planned Parenthood Federation of America , Miami, Florida.
J Womens Health (Larchmt). 2018 Mar;27(3):311-316. doi: 10.1089/jwh.2016.6144. Epub 2017 Oct 17.
The consequences of unsafe abortion are devastating to women, their families, and their communities. Medication abortion presents an important alternative to harmful self-induction practices and surgical intervention under questionable circumstances. In settings where mifepristone is unavailable, the use of misoprostol alone is a safe and effective option for terminating an unwanted pregnancy. Studies have demonstrated the safety and efficacy of administration of misoprostol by community health workers (CHW) for indications such as postpartum hemorrhage and treatment of incomplete abortion.
The current study assesses the safety and efficacy of CHW managing misoprostol-only abortion in the first trimester.
A retrospective review of clinical files of women who received abortion services in three countries in Latin America between April 2009 and December 2015 included analysis of 173 cases.
In 94% of cases, the pregnancy was terminated without any further intervention. In the remaining cases, clients were referred for manual vacuum aspiration. In four cases, a complication was reported by the provider. In one, the complication was promptly resolved through referral to a higher level of care; in the remaining three, the complication was resolved directly by the provider. In 98% of cases, women reported being satisfied with the treatment they received.
This study demonstrates that CHW are able to provide misoprostol-only abortion services to women effectively and safely. The benefits of this model of care also extend beyond the abortion service: CHW are able to offer women a comprehensive range of quality health services, including contraceptive services, increasing access to vital healthcare in areas with few other options.
不安全堕胎对妇女、她们的家庭和社区造成了毁灭性的后果。药物流产为有害的自我诱导行为和在可疑情况下进行手术干预提供了重要的替代选择。在米非司酮无法获得的情况下，单独使用米索前列醇是终止意外怀孕的安全有效选择。研究表明，社区卫生工作者（CHW）用于产后出血和治疗不完全流产等适应症的米索前列醇给药是安全有效的。
本研究评估 CHW 在孕早期管理单独使用米索前列醇终止妊娠的安全性和有效性。
对 2009 年 4 月至 2015 年 12 月期间在拉丁美洲三个国家接受堕胎服务的妇女的临床档案进行回顾性分析，共纳入 173 例病例。
94%的病例无需进一步干预即可终止妊娠。在其余病例中，患者被转诊接受手动真空抽吸。提供者报告了 4 例并发症。其中 1 例通过转至更高层次的医疗保健得到及时解决；其余 3 例由提供者直接解决。98%的患者对接受的治疗表示满意。
本研究表明，CHW 能够有效地、安全地为妇女提供单独使用米索前列醇的堕胎服务。这种护理模式的好处不仅限于堕胎服务：CHW 能够为妇女提供全面的优质卫生服务，包括避孕服务，增加了在其他选择较少的地区获得重要医疗保健的机会。
