Whitehouse Katherine, Fontanilla Tiana, Kim Leslie, Tschann Mary, Soon Reni, Salcedo Jennifer, Kaneshiro Bliss
University of Hawaii, John A. Burns School of Medicine, Department of Obstetrics, Gynecology & Women's Health, 1319 Punahou St., Ste. 824, Honolulu, HI 96826, USA.
University of Hawaii, John A. Burns School of Medicine, Department of Obstetrics, Gynecology & Women's Health, 1319 Punahou St., Ste. 824, Honolulu, HI 96826, USA.
Contraception. 2018 Jun;97(6):500-503. doi: 10.1016/j.contraception.2018.02.015. Epub 2018 Feb 25.
Our objective was to document current practices of abortion providers on the use of medications to decrease bleeding during surgical abortion.
We emailed surveys to 336 abortion providers through a professional listserv to elicit information on their use of medications to prevent and treat bleeding during first- and second-trimester surgical abortion.
One hundred sixty-eight (50%) providers responded to our survey. The majority were obstetrician-gynecologists (83%) working in an academic practice (66%). Most completed a fellowship in family planning (87%) and currently perform abortions up to 22 or 24weeks of gestation (63%). Seventy-two percent routinely used prophylactic medications for bleeding. Providers who routinely used medications to prevent bleeding most commonly chose vasopressin (83%). Providers preferred methylergonovine as a treatment for excessive bleeding in the second trimester, followed by misoprostol.
We found that most providers routinely use medications to prevent bleeding and use several different regimens to treat bleeding during abortion.
We found that surgical abortion providers use a range of medications to prevent and treat hemorrhage at the time of surgical abortion. Scant evidence is available to guide abortion providers on the use of medications to decrease hemorrhage during surgical abortion. To provide evidence-based recommendations for the prevention and treatment of clinically significant bleeding, researchers should target the most commonly used interventions.
我们的目的是记录堕胎提供者在手术流产期间使用药物减少出血的当前做法。
我们通过专业邮件列表向336名堕胎提供者发送了调查问卷，以获取他们在孕早期和孕中期手术流产期间使用药物预防和治疗出血的信息。
168名（50%）提供者回复了我们的调查。大多数是在学术机构工作的妇产科医生（83%）。大多数人完成了计划生育 fellowship（87%），目前进行妊娠22周或24周以内的堕胎手术（63%）。72%的人常规使用预防出血的药物。常规使用药物预防出血的提供者最常选择血管加压素（83%）。提供者更喜欢甲基麦角新碱作为孕中期出血过多的治疗药物，其次是米索前列醇。
我们发现大多数提供者常规使用药物预防出血，并使用几种不同的方案治疗流产期间的出血。
我们发现手术流产提供者在手术流产时使用一系列药物预防和治疗出血。几乎没有证据可指导堕胎提供者在手术流产期间使用药物减少出血。为了为预防和治疗具有临床意义的出血提供循证建议，研究人员应针对最常用的干预措施。
