Winikoff B, Sivin I, Coyaji K J, Cabezas E, Xiao B, Gu S, Du M K, Krishna U R, Eschen A, Ellertson C
Population Council, New York, NY 10017, USA.
Am J Obstet Gynecol. 1997 Feb;176(2):431-7. doi: 10.1016/s0002-9378(97)70511-8.
We investigated safety, efficacy, and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries.
Women (n = 1373) with amenorrhea < or = 56 days chose either surgical abortion (as provided routinely) or 600 mg of mifepristone followed after 48 hours by 400 micrograms of misoprostol. This is the appropriate design for studying safety, efficacy, and acceptability among women selecting medical abortion over available surgical services.
The medical regimen had more side effects, particularly bleeding, than did surgical abortion but very few serious side effects. Failure rates for medical abortion, although low, exceeded those for surgical abortion: 8.6% versus 0.4% (China), 16.0% versus 4.0% (Cuba), and 5.2% versus 0% (India). Nearly half of failures among medical clients were not true drug failures, however, but surgical interventions not medically necessary (acceptability failures or misdiagnoses). Women were satisfied with either method, but more preferred medical abortion.
Medical abortion can be safe, efficacious, and acceptable in developing countries.
我们在三个发展中国家调查了药物流产口服方案与手术流产相比的安全性、有效性和可接受性。
闭经≤56天的女性（n = 1373）选择手术流产（按常规提供）或服用600毫克米非司酮，48小时后再服用400微克米索前列醇。这是研究在可获得手术服务的情况下选择药物流产的女性的安全性、有效性和可接受性的合适设计。
药物流产方案比手术流产有更多的副作用，尤其是出血，但严重副作用很少。药物流产的失败率虽然较低，但超过了手术流产：中国为8.6%对0.4%，古巴为16.0%对4.0%，印度为5.2%对0%。然而，药物流产受术者中近一半的失败并非真正的药物失败，而是不必要的手术干预（可接受性失败或误诊）。女性对两种方法都满意，但更多人更喜欢药物流产。
在发展中国家，药物流产可以是安全、有效的且可接受的。
