PDF(Pubmed)
Abstract：
UNASSIGNED: Document the clinical outcomes of an outpatient medical management with procedural evacuation backup procedure for abortions between 18 weeks zero days to 23 weeks six days gestation.
UNASSIGNED: We conducted a retrospective medical records review of adult patients who received mifepristone and repeated misoprostol for second trimester abortion with procedural evacuation backup at an Arizona clinic between October 2017 and November 2021. We extracted patient demographics; pregnancy and medical history; and preoperative, intraoperative, and postoperative data. We assessed abortion outcomes, including procedure timing, mode of completion (medication alone or medications and procedural evacuation), and safety.
UNASSIGNED: All 359 patients had a complete abortion with 63.5% of patients completing with medication alone and 36.5% with procedural evacuation backup. The median time from first dose of misoprostol to fetal expulsion was six hours, among those who completed the abortion with medications alone. Of those who received procedural evacuation as backup, the median time for procedural evacuation was 10 minutes. The vast majority of patients (99.4%) did not have any adverse events. Two safety incidents (0.6%) occurred, a broad right ligament tear and a uterine rupture.
UNASSIGNED: Patients in one outpatient setting safely and effectively received medical management of second trimester abortion with procedural evacuation backup, and two thirds completed with medications alone.
UNASSIGNED: Outpatient settings may consider medical management of abortion between 18 and 24 weeks with procedural evacuation back-up as a safe, effective, and manageable second trimester abortion option. Additional research is needed on patient experience and satisfaction.
UNASSIGNED: We conducted a retrospective medical records review of adult patients who received mifepristone and repeated misoprostol for second trimester abortion with procedural evacuation backup at an Arizona clinic between October 2017 and November 2021. We extracted patient demographics; pregnancy and medical history; and preoperative, intraoperative, and postoperative data. We assessed abortion outcomes, including procedure timing, mode of completion (medication alone or medications and procedural evacuation), and safety.
UNASSIGNED: All 359 patients had a complete abortion with 63.5% of patients completing with medication alone and 36.5% with procedural evacuation backup. The median time from first dose of misoprostol to fetal expulsion was six hours, among those who completed the abortion with medications alone. Of those who received procedural evacuation as backup, the median time for procedural evacuation was 10 minutes. The vast majority of patients (99.4%) did not have any adverse events. Two safety incidents (0.6%) occurred, a broad right ligament tear and a uterine rupture.
UNASSIGNED: Patients in one outpatient setting safely and effectively received medical management of second trimester abortion with procedural evacuation backup, and two thirds completed with medications alone.
UNASSIGNED: Outpatient settings may consider medical management of abortion between 18 and 24 weeks with procedural evacuation back-up as a safe, effective, and manageable second trimester abortion option. Additional research is needed on patient experience and satisfaction.
摘要：
■记录妊娠18周零天至23周六天之间流产的门诊医疗管理的临床结果。
我们对2017年10月至2021年11月在亚利桑那州一家诊所接受米非司酮和重复米索前列醇治疗妊娠中期流产的成年患者进行了回顾性医疗记录审查。我们提取了患者的人口统计数据;怀孕和病史;和术前,术中,和术后数据。我们评估了流产结果,包括程序定时，完成方式（单独用药或药物和程序疏散），和安全。
■所有359例患者均完成了完全流产，其中63.5％的患者仅接受药物治疗，36.5％的患者接受了手术后送备份。从第一次服用米索前列醇到胎儿排出的中位时间为6小时，在那些单独用药物完成堕胎的人中。在那些接受程序疏散作为后援的人中，手术后送的中位时间为10分钟.绝大多数患者（99.4%）没有任何不良事件。发生两起安全事件(0.6%),右韧带撕裂和子宫破裂。
■在一个门诊环境中，患者安全有效地接受了中期妊娠流产的医疗管理，并进行了程序后送备份，三分之二的人完成了单独的药物治疗。
■门诊设置可以考虑在18至24周之间进行人工流产的医疗管理，并进行手术后送备份作为安全措施，有效,和可控的孕中期流产选择。需要对患者体验和满意度进行更多研究。
我们对2017年10月至2021年11月在亚利桑那州一家诊所接受米非司酮和重复米索前列醇治疗妊娠中期流产的成年患者进行了回顾性医疗记录审查。我们提取了患者的人口统计数据;怀孕和病史;和术前,术中,和术后数据。我们评估了流产结果,包括程序定时，完成方式（单独用药或药物和程序疏散），和安全。
■所有359例患者均完成了完全流产，其中63.5％的患者仅接受药物治疗，36.5％的患者接受了手术后送备份。从第一次服用米索前列醇到胎儿排出的中位时间为6小时，在那些单独用药物完成堕胎的人中。在那些接受程序疏散作为后援的人中，手术后送的中位时间为10分钟.绝大多数患者（99.4%）没有任何不良事件。发生两起安全事件(0.6%),右韧带撕裂和子宫破裂。
■在一个门诊环境中，患者安全有效地接受了中期妊娠流产的医疗管理，并进行了程序后送备份，三分之二的人完成了单独的药物治疗。
■门诊设置可以考虑在18至24周之间进行人工流产的医疗管理，并进行手术后送备份作为安全措施，有效,和可控的孕中期流产选择。需要对患者体验和满意度进行更多研究。
