Sium Abraham Fessehaye, Prager Sarah, Abubeker Ferid A, Don Eliseo Lucero-Prisno, Gudu Wondimu
Department of Obstetrics and Gynecology St. Paul's Hospital Millennium Medical College (SPHMMC) Addis Ababa Ethiopia.
Complex Family Planning Division, Department of Obstetrics and Gynecology UW Medicine Seattle Washington USA.
Public Health Chall. 2023 Jul 28;2(3):e113. doi: 10.1002/puh2.113. eCollection 2023 Sep.
There are no clear data driving most clinical recommendations for abortion care in women with underlying medical conditions, such as cardiac disease. Current abortion practice in such women is based on limited retrospective studies, mainly case reports and case series. In our institution (a tertiary center in Ethiopia), we practice a multidisciplinary team approach to abortion care for patients with medical conditions.
Describe the value of a multidisciplinary team approach in abortion care in patients with underlying medical conditions.
This is a retrospective descriptive analysis of abortion care in women with underlying medical conditions (cardiac and noncardiac medical conditions) over a 5-year period (November 2016-October 2021) at St. Paul's Hospital Millennium Medical College, in Ethiopia. Data were extracted by reviewing patients' medical records using a structured questionnaire. Simple descriptive statistics were applied for analysis using SPSS version 23. Results are presented as frequencies and percentages.
Fifteen induced abortion cases in women with underlying medical conditions were analyzed, out of which 11 were in women who were critically ill. The median gestational age was 20 weeks. Ten subjects, 10/15 (66.7%), had a cardiac condition, whereas the rest 5/15 (33.3%) were noncardiac cases. Ten out of the 11 critically ill patients were managed under multidisciplinary team approach, and there were no complications encountered. Out of these, 7/10 (70%) received medication abortion care between 19 and 25 weeks gestation, including 5 cardiac patients with New York Heart Association-III and IV conditions.
In this study, more than three quarters of women with medical conditions who had abortion care were critically ill, and almost all of them were managed with a multidisciplinary team approach. None of the patients suffered a deterioration of their medical conditions, demonstrating the utility of incorporating a multidisciplinary team approach during abortion care for such cases.
对于患有基础疾病（如心脏病）的女性，目前尚无明确数据支持大多数堕胎护理的临床建议。此类女性目前的堕胎做法基于有限的回顾性研究，主要是病例报告和病例系列。在我们机构（埃塞俄比亚的一家三级中心），我们对患有基础疾病的患者采用多学科团队方法进行堕胎护理。
描述多学科团队方法在患有基础疾病的患者堕胎护理中的价值。
这是一项对埃塞俄比亚圣保罗医院千禧医学院5年期间（2016年11月至2021年10月）患有基础疾病（心脏和非心脏疾病）的女性堕胎护理的回顾性描述性分析。通过使用结构化问卷查阅患者病历提取数据。使用SPSS 23版进行简单描述性统计分析。结果以频率和百分比表示。
分析了15例患有基础疾病女性的人工流产病例，其中11例为重症女性。中位孕周为20周。10名受试者，10/15（66.7%）患有心脏病，其余5/15（33.3%）为非心脏病例。11例重症患者中有10例采用多学科团队方法进行管理，未出现并发症。其中，7/10（70%）在妊娠19至25周期间接受了药物流产护理，包括5例纽约心脏病协会III级和IV级的心脏病患者。
在本研究中，接受堕胎护理的患有基础疾病的女性中超过四分之三为重症患者，几乎所有患者都采用多学科团队方法进行管理。没有患者的病情恶化，这表明在此类病例的堕胎护理中采用多学科团队方法的实用性。
