背景:先前的系统评价得出的结论是,由非医生提供者进行的医疗终止妊娠(TOP)可能与医生提供的药物一样有效且安全。非医生提供者对不完全流产的药物治疗以及接受治疗的妇女接受非医生提供者的TOP之前没有进行过审查。
目的:为了审查有效性,安全,和早期妊娠医学TOP的可接受性,包括不完全流产的治疗,由训练有素的非医生提供者提供。
方法:开发了使用适当医学主题词的搜索策略。电子数据库(PubMed,Popline,科克伦,CINAHL,Embase,和ClinicalTrials.gov)从开始到2016年4月进行了搜索。纳入随机对照试验和比较观察性研究。
方法:对纳入的随机对照试验进行了关于有效性和女性可接受性结局的Meta分析。使用GRADE方法评估研究局限性来确定证据的确定性,效果的一致性,不精确,间接性和出版偏见。
结果:共纳入6篇论文。非医生提供者进行的不完全流产的医疗TOP和医疗治疗可能与医生进行的一样有效(RR1.00;95%CI0.99-1.01)。妇女的接受,报告为对分配的提供商的总体满意度,组间可能同样高(RR1.00;95%CI1.00-1.01)。
结论:由受过培训的非医生提供者提供的不完全流产的医疗TOP和医疗治疗可能与医生提供的妇女一样有效和可接受。
结论:由医生和非医生进行的医学终止妊娠同样有效且可接受。
BACKGROUND: Previous systematic reviews have concluded that medical termination of pregnancy (TOP) performed by non-doctor providers may be as effective and safe as when provided by doctors. Medical treatment of incomplete miscarriage by non-doctor providers and the treated women\'s acceptance of non-doctor providers of TOP has not previously been reviewed.
OBJECTIVE: To
review the effectiveness, safety, and acceptability of first-trimester medical TOP, including medical treatment for incomplete miscarriage, by trained non-doctor providers.
METHODS: A search strategy using appropriate medical subject headings was developed. Electronic databases (PubMed, Popline, Cochrane, CINAHL, Embase, and ClinicalTrials.gov) were searched from inception through April 2016. Randomised controlled trials and comparative observational studies were included.
METHODS: Meta-analyses were performed for included randomised controlled trials regarding the outcomes of effectiveness and acceptability to women. Certainty of evidence was established using the GRADE approach assessing study limitations, consistency of effect, imprecision, indirectness and publication bias.
RESULTS: Six papers were included. Medical TOP and medical treatment of incomplete miscarriage is probably equally effective when performed by non-doctor providers as when performed by doctors (RR 1.00; 95% CI 0.99-1.01). Women\'s acceptance, reported as overall satisfaction with the allocated provider, is probably equally high between groups (RR 1.00; 95% CI 1.00-1.01).
CONCLUSIONS: Medical TOP and medical treatment of incomplete miscarriage provided by trained non-doctor providers is probably equally as effective and acceptable to women as when provided by doctors.
CONCLUSIONS: Medical termination of pregnancy performed by doctors and non-doctors can be equally effective and acceptable.