Fok Wing Kay, Mark Alice
Stanford University, Stanford, California.
National Abortion Federation, Washington, DC, USA.
Curr Opin Obstet Gynecol. 2018 Dec;30(6):394-399. doi: 10.1097/GCO.0000000000000498.
Medical abortion offers a well tolerated and effective method to terminate early pregnancy, but remains underutilized in the United States. Over the last decade, 'telemedicine' has been studied as an option for medical abortion to improve access when patients and providers are not together. A number of studies have explored various practice models and their feasibility as an alternative to in-person service provision.
A direct-to-clinic model of telemedicine medical abortion has similar efficacy with no increased risk of significant adverse events when compared with in-person abortion. A direct-to-consumer model is currently being studied in the United States. International models of direct-to-consumer medical abortion have shown promising results.
The introduction of telemedicine into abortion care has been met with early success. Currently, there are limitations to the reach of telemedicine because of specific restrictions on mifepristone in the United States as well as laws that specifically prohibit telemedicine for abortion. If these barriers are removed, telemedicine can potentially increase abortion access.
药物流产为终止早期妊娠提供了一种耐受性良好且有效的方法，但在美国仍未得到充分利用。在过去十年中，“远程医疗”作为药物流产的一种选择进行了研究，以便在患者和提供者不在同一地点时改善可及性。多项研究探索了各种实践模式及其作为面对面服务替代方案的可行性。
与面对面流产相比，远程医疗药物流产的直接到诊所模式具有相似的疗效，且重大不良事件风险没有增加。直接面向消费者的模式目前正在美国进行研究。国际上直接面向消费者的药物流产模式已显示出有前景的结果。
将远程医疗引入流产护理已取得初步成功。目前，由于美国对米非司酮的特定限制以及专门禁止远程医疗用于流产的法律，远程医疗的覆盖范围存在局限性。如果消除这些障碍，远程医疗有可能增加流产的可及性。
