Fiala Christian, Cameron Sharon, Bombas Teresa, Parachini Mirella, Agostini Aubert, Lertxundi Roberto, Lubusky Marek, Saya Laurence, Gemzell Danielsson Kristina
a Gynmed Clinic , Vienna , Austria.
b Department of Women's and Children's Health, Division of Obstetrics and Gynaecology , Karolinska Institutet and Karolinska University Hospital , Stockholm , Sweden.
Eur J Contracept Reprod Health Care. 2018 Dec;23(6):451-457. doi: 10.1080/13625187.2018.1535058. Epub 2019 Jan 2.
Medical termination of pregnancy (MToP, or medical abortion) is a highly effective method with a reported efficacy of 95-98%. However, different criteria are currently used to define success, and there are different recommendations for the treatment of what is considered a failure of MToP. This work was undertaken to develop a consensus around a set of well-defined MToP outcomes, as recommended by the Core Outcomes in Women's and Newborn Health initiative.
A literature search was made of national and international guidelines and of recommendations of expert groups for various outcomes of MToP and subsequent management. Based on a review of the findings, a group of European experts in MToP undertook a consensus process to agree on a set of core MToP outcomes.
The following core MToP outcomes were defined: success, failure (ongoing pregnancy), need for additional treatment (medical or surgical) to complete MToP (missed abortion, incomplete abortion), complications and the woman's request for additional treatment (medical or surgical). Recommendations for the management of unsuccessful outcomes were also formulated.
New definitions of MToP outcomes that are more focused on objective criteria and consequently less dependent on provider interpretation are proposed. This should allow better comparison of the efficacy of different regimens and improve the management of failed or incomplete abortion.
药物流产是一种高效的方法，据报道其有效率为95%-98%。然而，目前用于定义成功的标准不同，对于药物流产失败的治疗也有不同的建议。这项工作是按照妇女和新生儿健康核心结局倡议的建议，围绕一组明确界定的药物流产结局达成共识。
对国家和国际指南以及专家组关于药物流产各种结局及后续处理的建议进行文献检索。基于对研究结果的审查，一组欧洲药物流产专家开展了一个共识过程，以就一组核心药物流产结局达成一致。
定义了以下核心药物流产结局：成功、失败（持续妊娠）、完成药物流产需要额外治疗（药物或手术，稽留流产、不全流产）、并发症以及女性要求额外治疗（药物或手术）。还制定了对未成功结局的处理建议。
提出了更侧重于客观标准、因此较少依赖提供者解释的药物流产结局新定义。这应能更好地比较不同方案的疗效，并改善稽留流产或不全流产的处理。
