Saavedra-Avendano Biani, Botta María Paula, Chaumet Dolores, Macagno Berenice, Ortiz-Avendano Guillermo Antonio
Ipas LAC, Mexico City, Mexico.
CEMAR, Rosario, Santa Fe, Argentina.
Reprod Health. 2025 May 24;22(1):91. doi: 10.1186/s12978-025-02036-8.
In December 2020, Argentina passed Law 27.610, legalizing elective abortion up to 14 + 6 weeks and beyond in cases of rape or health risks. This study aims to analyze the sociodemographic characteristics of users who opted or were referred for manual vacuum aspiration (MVA) services at an a ambulatory medical center in Argentina before and after the legal reform, and to assess the safety and effectiveness of outpatient MVA procedures for pregnancies up to 14 + 6 weeks.
Observational study using clinical data from patients up to 14 + 6 weeks gestation (n = 1,861) who sought or were referred for outpatient MVA abortion at a public healthcare facility in Rosario, Argentina (2017-2023). We analyze changes in users' sociodemographic characteristics before and after the legal reform and assess the safety and effectiveness of ambulatory MVA abortion by gestational age (< 13 weeks vs. 13-14 weeks). A logistic regression tested associations between sociodemographic, procedural, and reproductive factors, and receiving MVA after 12 weeks.
Of the 1,861 MVA abortions, 85% (n = 1,590) were provided before 13 weeks' gestation, and 15% (n = 271) occurred between 13-14 weeks. After the legal reform, more users accessed outpatient MVA services beyond 12 weeks (7% vs. 22%; p < 0.05: before and after the legal change, respectively), including individuals with lower education levels (46% vs. 54%; p < 0.05:), informal employment (34% vs. 47%; p < 0.05), without healthcare insurance (72% vs. 90%; p < 0.05), and nulliparity (18% vs. 30%; p < 0.05). The success rate of ambulatory MVA abortion was 99.9%, with 0.4% (n = 7) adverse events; no statistically significant differences by gestational age groups (< 13 weeks vs. 13-14 weeks). The legal reform was positively associated with accessing MVA abortion after 12 weeks.
The legal reform improved access to safe ambulatory MVA abortion services up to 14 + 6 weeks' gestation, particularly for socially disadvantaged users. MVA abortion, both before 13 weeks and at 13-14 weeks, demonstrated a high success rate (99.9%) with minimal adverse events.
2020年12月，阿根廷通过了第27.610号法律，将妊娠14 + 6周以内的选择性堕胎合法化，强奸或存在健康风险的情况不受此孕周限制。本研究旨在分析阿根廷一项法律改革前后，在一家门诊医疗中心选择或被转诊接受手动真空吸引术（MVA）服务的使用者的社会人口学特征，并评估门诊MVA手术对妊娠14 + 6周以内的安全性和有效性。
采用观察性研究，使用来自阿根廷罗萨里奥一家公共医疗机构中妊娠14 + 6周以内（n = 1861）寻求或被转诊接受门诊MVA堕胎的患者的临床数据。我们分析了法律改革前后使用者社会人口学特征的变化，并按孕周（<13周与13 - 14周）评估门诊MVA堕胎的安全性和有效性。通过逻辑回归检验社会人口学、手术和生殖因素与12周后接受MVA之间的关联。
在1861例MVA堕胎中，85%（n = 1590）在妊娠13周前进行，15%（n = 271）发生在13 - 14周之间。法律改革后，更多使用者在12周后接受门诊MVA服务（分别为7%和22%；p < 0.05：法律变更前后），包括教育程度较低者（46%对54%；p < 0.05）、非正规就业者（34%对47%；p < 0.05）、没有医疗保险者（72%对90%；p < 0.05）以及未生育者（18%对30%；p < 0.05）。门诊MVA堕胎的成功率为99.9%，不良事件发生率为0.4%（n = 7）；不同孕周组（<13周与13 - 14周）之间无统计学显著差异。法律改革与12周后接受MVA堕胎呈正相关。
法律改革改善了妊娠14 + 6周以内安全的门诊MVA堕胎服务的可及性，特别是对社会弱势群体而言。妊娠13周前和13 - 14周的MVA堕胎均显示出高成功率（99.9%）且不良事件极少。
