Costescu Dustin, Guilbert Édith
Hamilton, ON (Co-chair).
Québec City, QC (Co-chair).
J Obstet Gynaecol Can. 2018 Jun;40(6):750-783. doi: 10.1016/j.jogc.2017.12.010.
This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care.
Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs.
Women with an unintended or abnormal first or second trimester pregnancy.
PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched.
The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request.
BENEFITS, HARMS, AND/OR COSTS: IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines.
本指南回顾了与手术诱导流产（IA）和孕中期药物流产相关的证据，包括术前和术后护理。
目前或打算提供和/或讲授IA的妇科医生、家庭医生、护士、助产士、住院医生及其他医疗保健提供者。
意外怀孕或孕早期或孕中期出现异常情况的女性。
使用关键词“孕早期手术流产”“孕中期手术流产”“孕中期药物流产”“扩张和刮宫术”“引产流产”“杀胎”“宫颈准备”“宫颈扩张”“流产并发症”在PubMed、Medline和Cochrane数据库中进行检索。结果仅限于1979年至2017年7月发表的英文或法文系统评价、随机对照试验、临床试验和观察性研究。查阅了国内和国际临床实践指南以进行综述。未检索灰色文献。
本文件中的证据质量使用推荐分级、评估、制定和评价（GRADE）方法框架进行评级。如有需要，可提供研究结果总结。
益处、危害和/或成本：IA是安全有效的。IA的益处超过潜在危害或成本。这些指南未发现新的直接危害或成本。
