PDF(Pubmed)
Abstract：
UNASSIGNED: Mifepristone-misoprostol treatment for medical abortion and miscarriage are safe and effective. This study aimed to assess clinical factors associated with subsequent surgical intervention after medical termination of early viable or non-viable pregnancy.
UNASSIGNED: This retrospective, single-center study included women who underwent medical abortion at Taipei Medical University between January 2010 and December 2019. A total of 1,561 subjects, with 1,080 viable and 481 non-viable pregnancies, who were treated with oral mifepristone 600 mg followed by misoprostol 600 mg 48 h later were included. Data of all pregnancies and medical termination of pregnancy were evaluated using regression analysis. The main outcome was successful termination of pregnancy.
UNASSIGNED: The success rate of medical abortion was comparable in women with viable and non-viable (92.13% vs. 92.93%) pregnancies. Besides retained tissue, more existing pregnancies with ultrasonographic findings were found in the non-viable pregnancy group than in the viable pregnancy group (29.4% vs. 14.1%, p = 0.011). Multivariate analysis showed that previous delivery was an independent risk factor for failed medical abortion among all included cases. In women with viable pregnancy, longer gestational age [adjusted odds ratio (aOR): 1.483, 95% confidence interval (CI): 1.224-1.797, p < 0.001] and previous Cesarean delivery (aOR: 2.177, 95% CI: 1.167-40.62, p = 0.014) were independent risk factors for failed medical abortion. Number of Cesarean deliveries (aOR: 1.448, 95% CI: 1.029-2.039, p = 0.034) was an independent risk factor for failed medication abortion in women with non-viable pregnancies.
UNASSIGNED: This is the first cohort study to identify risk factors for subsequent surgical intervention in women with viable or non-viable pregnancies who had undergone early medically induced abortions. The success rate of medical abortion is comparable in women with viable and non-viable pregnancies. Previous delivery is an independent risk factor for failed medical abortion. Clinical follow-up may be necessary for women who are at risk of subsequent surgical intervention.
UNASSIGNED: This retrospective, single-center study included women who underwent medical abortion at Taipei Medical University between January 2010 and December 2019. A total of 1,561 subjects, with 1,080 viable and 481 non-viable pregnancies, who were treated with oral mifepristone 600 mg followed by misoprostol 600 mg 48 h later were included. Data of all pregnancies and medical termination of pregnancy were evaluated using regression analysis. The main outcome was successful termination of pregnancy.
UNASSIGNED: The success rate of medical abortion was comparable in women with viable and non-viable (92.13% vs. 92.93%) pregnancies. Besides retained tissue, more existing pregnancies with ultrasonographic findings were found in the non-viable pregnancy group than in the viable pregnancy group (29.4% vs. 14.1%, p = 0.011). Multivariate analysis showed that previous delivery was an independent risk factor for failed medical abortion among all included cases. In women with viable pregnancy, longer gestational age [adjusted odds ratio (aOR): 1.483, 95% confidence interval (CI): 1.224-1.797, p < 0.001] and previous Cesarean delivery (aOR: 2.177, 95% CI: 1.167-40.62, p = 0.014) were independent risk factors for failed medical abortion. Number of Cesarean deliveries (aOR: 1.448, 95% CI: 1.029-2.039, p = 0.034) was an independent risk factor for failed medication abortion in women with non-viable pregnancies.
UNASSIGNED: This is the first cohort study to identify risk factors for subsequent surgical intervention in women with viable or non-viable pregnancies who had undergone early medically induced abortions. The success rate of medical abortion is comparable in women with viable and non-viable pregnancies. Previous delivery is an independent risk factor for failed medical abortion. Clinical follow-up may be necessary for women who are at risk of subsequent surgical intervention.
摘要：
■米非司酮-米索前列醇治疗药物流产和流产是安全有效的。本研究旨在评估早期存活或无存活妊娠药物终止后与后续手术干预相关的临床因素。
■这次回顾展，单中心研究纳入了2010年1月至2019年12月在台北医科大学接受药物流产的女性.共1561个科目,有1,080例可行妊娠和481例非可行妊娠，包括口服米非司酮600mg，然后在48小时后口服米索前列醇600mg。使用回归分析评估所有妊娠和医学终止妊娠的数据。主要结局是成功终止妊娠。
■在有生命和无生命的妇女中，药物流产的成功率相当（92.13％vs.92.93%）怀孕。除了保留的组织，与可行妊娠组相比，在非可行妊娠组中发现了更多具有超声检查结果的现有妊娠（29.4％vs.14.1%,p=0.011)。多因素分析显示，在所有纳入病例中，既往分娩是药物流产失败的独立危险因素。在有可行怀孕的女性中，胎龄较长[校正比值比(aOR):1.483,95%置信区间(CI):1.224~1.797,p<0.001]和既往剖宫产(aOR:2.177,95%CI:1.167~40.62,p=0.014)是药物流产失败的独立危险因素.剖宫产次数（aOR：1.448，95％CI：1.029-2.039，p=0.034）是无存活妊娠妇女药物流产失败的独立危险因素。
这是第一项队列研究，旨在确定在进行早期药物引产的有存活或无存活妊娠的妇女中进行后续手术干预的危险因素。在有可行妊娠和无可行妊娠的妇女中，药物流产的成功率相当。既往分娩是药物流产失败的独立危险因素。对于有后续手术干预风险的女性，可能需要进行临床随访。
■这次回顾展，单中心研究纳入了2010年1月至2019年12月在台北医科大学接受药物流产的女性.共1561个科目,有1,080例可行妊娠和481例非可行妊娠，包括口服米非司酮600mg，然后在48小时后口服米索前列醇600mg。使用回归分析评估所有妊娠和医学终止妊娠的数据。主要结局是成功终止妊娠。
■在有生命和无生命的妇女中，药物流产的成功率相当（92.13％vs.92.93%）怀孕。除了保留的组织，与可行妊娠组相比，在非可行妊娠组中发现了更多具有超声检查结果的现有妊娠（29.4％vs.14.1%,p=0.011)。多因素分析显示，在所有纳入病例中，既往分娩是药物流产失败的独立危险因素。在有可行怀孕的女性中，胎龄较长[校正比值比(aOR):1.483,95%置信区间(CI):1.224~1.797,p<0.001]和既往剖宫产(aOR:2.177,95%CI:1.167~40.62,p=0.014)是药物流产失败的独立危险因素.剖宫产次数（aOR：1.448，95％CI：1.029-2.039，p=0.034）是无存活妊娠妇女药物流产失败的独立危险因素。
这是第一项队列研究，旨在确定在进行早期药物引产的有存活或无存活妊娠的妇女中进行后续手术干预的危险因素。在有可行妊娠和无可行妊娠的妇女中，药物流产的成功率相当。既往分娩是药物流产失败的独立危险因素。对于有后续手术干预风险的女性，可能需要进行临床随访。
