Edwards J, Carson S A
Planned Parenthood of Houston and Southeast Texas 77004, USA.
Am J Obstet Gynecol. 1997 May;176(5):1101-6. doi: 10.1016/s0002-9378(97)70410-1.
The previously held dictum that elective abortion before 6 weeks' gestation carried greater risks than a later procedure was challenged by this protocol.
This study evaluated a protocol for abortion before the customary 6 weeks' gestation. Patients willing to return to the clinic within 72 hours were given the option of elective abortion even when no gestational sac could be visualized with transvaginal ultrasonography. When no chorionic membrane with villi was seen in the curettings, postoperative serum levels of beta-human chorionic gonadotropin confirmed complete evacuation or diagnosed ectopic pregnancy.
In 1530 abortion procedures at < 6 weeks' gestation by ultrasonographic criteria no serious complications occurred. In addition, 9 (0.67%) unsuspected ectopic pregnancies were diagnosed.
Abortion before 6 weeks' gestation is safe, given close surveillance. Early termination combined with vaginal ultrasonography and follow-up with beta-human chorionic gonadotropin measurements allows diagnosis of early, unsuspected ectopic pregnancy. Ectopic pregnancy was found to be uncommon in women requesting early abortion.
本方案对先前认为妊娠6周前进行选择性流产比妊娠后期手术风险更大的论断提出了挑战。
本研究评估了一项在妊娠6周前进行流产的方案。愿意在72小时内返回诊所的患者，即使经阴道超声检查未发现妊娠囊，也可选择进行选择性流产。当刮宫标本中未见有绒毛的绒毛膜时，术后血清β-人绒毛膜促性腺激素水平可确认完全清除或诊断为异位妊娠。
根据超声标准，在1530例妊娠<6周的流产手术中未发生严重并发症。此外，诊断出9例（0.67%）未被怀疑的异位妊娠。
在密切监测下，妊娠6周前进行流产是安全的。早期终止妊娠并结合阴道超声检查以及β-人绒毛膜促性腺激素测量进行随访，有助于诊断早期未被怀疑的异位妊娠。在要求早期流产的女性中，异位妊娠并不常见。
