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意外妊娠的持续

Continuation of Unintended Pregnancy.

作者信息

Ayerbe Luis, Pérez-Piñar María, Del Burgo Cristina López, Burgueño Eduardo

机构信息

Strangeways Laboratory, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.

Carnarvon Medical Centre, Southend-on-Sea, United Kingdom.

出版信息

Linacre Q. 2019 May;86(2-3):161-167. doi: 10.1177/0024363919838368. Epub 2019 Mar 24.

Abstract

BACKGROUND

Forty-four percent of all pregnancies worldwide are unintended. Induced abortion has drawn a lot of attention from clinicians and policy makers, and the care for women requesting it has been covered in many publications. However, abortion challenges the values of many women, is associated with negative emotions, and has its own medical complications. Women have the right to discuss their unintended pregnancy with a clinician and receive elaborate information about other options to deal with it. Continuing an unintended pregnancy, and receiving the necessary care and support for it, is also a reproductive right of women. However, the provision of medical information and support required for the continuation of an unintended pregnancy has hardly been approached in the medical literature.

OBJECTIVE

This review presents a clinical approach to unintentionally pregnant patients and describes the information and support that can be offered for the continuation of the unintended pregnancy.

DISCUSSION

Clinicians should approach patients with an unintended pregnancy with a sympathetic tone in order to provide the most support and present the most complete options. A complete clinical history can help frame the problem and identify concerns related to the pregnancy. Any underlying medical or obstetric problems can be discussed. A social history, that includes the personal support from the patient's partner, parents, and siblings, can be taken. Doctors should also be alert of possible cases of violence from the partner or child abuse in adolescent patients. Finally, the clinician can provide the first information regarding the social care available and refer the patients for further support. For women who continue an unintended pregnancy, clinicians should start antenatal care immediately.

CONCLUSION

Unintentionally pregnant women deserve a supportive and complete response from their clinicians, who should inform about, and sometimes activate, all the resources available for the continuation of unintended pregnancy.

SUMMARY

Forty-four percent of all pregnancies worldwide are unintended. Induced abortion has drawn a lot of attention and the care for women requesting it has been covered in many publications. However, abortion challenges the values of many women, is associated with negative emotions, and has its own medical complications. Women have the right to discuss their unintended pregnancy with a clinician and receive elaborate information about other options to deal with it. Continuing an unintended pregnancy, and receiving the necessary care and support for it, is also a reproductive right of women. However, the provision of medical information and support required for the continuation of an unintended pregnancy has hardly been approached in the medical literature. This review presents a clinical approach to unintentionally pregnant patients and describes the information and support that can be offered for the continuation of the unintended pregnancy. Clinicians should approach patients with an unintended pregnancy with a sympathetic tone. A complete clinical history can help frame the problem and identify concerns related to the pregnancy. Any underlying medical or obstetric problems can be discussed. A social history, that includes the personal support from the patient's partner, parents, and siblings, can be taken. Doctors should also be alert of possible cases of violence from the partner or child abuse in adolescent patients. Finally, the clinician can provide the first information regarding the social care available and refer the patients for further support. For women who continue an unintended pregnancy, clinicians should start antenatal care immediately.

摘要

背景

全球44%的怀孕属于意外怀孕。人工流产引起了临床医生和政策制定者的广泛关注,许多出版物都涵盖了对要求人工流产的女性的护理。然而,人工流产挑战了许多女性的价值观,与负面情绪相关,且有其自身的医学并发症。女性有权与临床医生讨论她们的意外怀孕情况,并获得关于处理意外怀孕的其他选择的详细信息。继续意外怀孕并为此获得必要的护理和支持,也是女性的一项生殖权利。然而,医学文献中几乎没有涉及继续意外怀孕所需的医学信息和支持的提供。

目的

本综述提出了一种针对意外怀孕患者的临床方法,并描述了可为继续意外怀孕提供的信息和支持。

讨论

临床医生应以同情的语气对待意外怀孕的患者,以便提供最大的支持并呈现最完整的选择。完整的临床病史有助于明确问题并识别与怀孕相关的担忧。可以讨论任何潜在的医学或产科问题。可以了解社会史,包括患者伴侣、父母和兄弟姐妹提供的个人支持。医生还应警惕伴侣可能的暴力行为或青少年患者中的虐待儿童情况。最后,临床医生可以提供有关可用社会护理的初步信息,并将患者转介以获得进一步支持。对于继续意外怀孕的女性,临床医生应立即开始产前护理。

结论

意外怀孕的女性理应得到临床医生的支持和全面回应,临床医生应告知并有时启动所有可用于继续意外怀孕的资源。

总结

全球44%的怀孕属于意外怀孕。人工流产引起了广泛关注,许多出版物都涵盖了对要求人工流产的女性的护理。然而,人工流产挑战了许多女性的价值观,与负面情绪相关,且有其自身的医学并发症。女性有权与临床医生讨论她们的意外怀孕情况,并获得关于处理意外怀孕的其他选择的详细信息。继续意外怀孕并为此获得必要的护理和支持,也是女性的一项生殖权利。然而,医学文献中几乎没有涉及继续意外怀孕所需的医学信息和支持的提供。本综述提出了一种针对意外怀孕患者的临床方法,并描述了可为继续意外怀孕提供的信息和支持。临床医生应以同情的语气对待意外怀孕的患者。完整的临床病史有助于明确问题并识别与怀孕相关的担忧。可以讨论任何潜在的医学或产科问题。可以了解社会史,包括患者伴侣、父母和兄弟姐妹提供的个人支持。医生还应警惕伴侣可能的暴力行为或青少年患者中的虐待儿童情况。最后,临床医生可以提供有关可用社会护理的初步信息,并将患者转介以获得进一步支持。对于继续意外怀孕的女性,临床医生应立即开始产前护理。

相似文献

1
Continuation of Unintended Pregnancy.意外妊娠的持续
Linacre Q. 2019 May;86(2-3):161-167. doi: 10.1177/0024363919838368. Epub 2019 Mar 24.
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Canadian Contraception Consensus (Part 2 of 4).加拿大避孕共识(共四部分,第二部分)
J Obstet Gynaecol Can. 2015 Nov;37(11):1033-9. doi: 10.1016/s1701-2163(16)30054-8.
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Canadian Contraception Consensus (Part 1 of 4).加拿大避孕共识(共4部分,第1部分)
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J Obstet Gynaecol Can. 2015 Aug;37(8):740-756. doi: 10.1016/S1701-2163(15)30180-8.

本文引用的文献

3
Abortion: access and safety worldwide.堕胎:全球范围内的可及性与安全性
Lancet. 2018 Mar 24;391(10126):1121. doi: 10.1016/S0140-6736(18)30624-X.
5
Options Counseling for the Pregnant Adolescent Patient.青少年孕妇的选择咨询。
Pediatrics. 2017 Sep;140(3). doi: 10.1542/peds.2017-2274. Epub 2017 Aug 21.

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