induced termination of pregnancy

  • 文章类型: Journal Article
    这项研究旨在评估先前手术终止妊娠(STP)对接受IVF/ICSIFET周期的女性妊娠结局的影响。回顾性队列研究。连云港市妇幼保健院生殖中心.数据来自2014年1月至2020年12月进行的所有IVF/ICSIFET周期。本研究包括总共761个符合标准的周期。主要结局指标是临床妊娠和活产率。次要结局指标是生化妊娠率,自然流产率,和早产率。在对一系列潜在的混杂因素进行调整后,与未接受过STP的女性相比,既往STP是降低FET周期临床妊娠率的影响因素(OR=0.614,95%CI0.413~0.911,P=0.016).既往STP对活产率的影响无统计学意义。(OR=0.745,95%CI0.495~1.122,P=0.159)。此外,与仅1次流产相比,既往STP数量的增加是降低临床妊娠率和活产率的独立危险因素(OR=0.399,95%CI0.162-0.982,p=0.046;OR=0.32,95%CI0.119-0.857,p=0.023).先前的STP是导致FET周期临床妊娠率下降的独立因素。
    This study aimed to evaluate the effect of previous surgical termination of pregnancy (STP) on pregnancy outcomes in women undergoing FET cycles of IVF/ICSI. Retrospective cohort study. Reproductive Center of Maternal and Child Health Care Hospital in Lianyungang city. Data were selected from all IVF/ICSI FET cycles performed between January 2014 and December 2020. A total of 761 cycles met the criteria were included in this study. The primary outcome measures were clinical pregnancy and live birth rates. Secondary outcome measures were biochemical pregnancy rate, spontaneous abortion rate, and preterm birth rate. After adjustments for a series of potential confounding factors, the previous STP was an influential factor in reducing FET cycle clinical pregnancy rate compared with women who had not previously undergone STP (OR = 0.614, 95% CI 0.413-0.911, P = 0.016). The effect of the previous STP on the live birth rate was not statistically significant. (OR = 0.745, 95% CI 0.495-1.122, P = 0.159). Also, an increase in the number of previous STPs relative to only 1-time abortion was an independent risk factor in reducing clinical pregnancy rate and live birth rate (OR = 0.399,95% CI 0.162-0.982, p = 0.046; OR = 0.32,95% CI 0.119-0.857, p = 0.023). Previous STP was an independent factor contributing to the decline in FET cycle clinical pregnancy rates.
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  • 文章类型: Journal Article
    OBJECTIVE: Intrauterine adhesions (IUAs) are a problematic complication after termination of pregnancy, but their incidence is unknown. Our objective was to assess the incidence of IUAs following induced termination of pregnancy and the risk factors for IUAs.
    METHODS: Retrospective cohort study.
    METHODS: A nationwide registry study.
    METHODS: All women undergoing induced termination of pregnancy (n = 80 015) in Finland between 2000 and 2008.
    METHODS: The data were retrieved from the Finnish Abortion Registry and the Hospital Discharge Registry. The diagnosis of IUAs or complications was based on the diagnostic codes (International Statistical Classification of Diseases and Related Health Problems 10th Revision, ICD-10) and operative codes according to the Nordic Medico-Statistical Committee (NOMESCO) Classification of Surgical Procedures (NCSP). IUAs were defined as ICD-10 code N85.6 or operative code LCG02. A subanalysis of IUA cases and five matched controls was performed.
    METHODS: The incidence of and risk factors for IUAs.
    RESULTS: A total of 12 (1.5 per 10 000) IUA diagnoses were identified from 79 960 eligible induced terminations of pregnancy. The rate of IUAs was 1.5 and 2.0 cases per 10 000 terminations of pregnancy following medically and surgically induced termination of pregnancy, respectively (P = 0.19). In a subgroup analysis of IUA cases and five matched controls, surgical treatment of the remaining products of conception following termination of pregnancy significantly increased the risk of IUAs (odds ratio, OR 5.50; 95% confidence interval, 95% CI 1.46-20.79; P = 0.012).
    CONCLUSIONS: IUAs that require further treatment are rare after an induced termination of pregnancy. Surgical evacuation following medical or surgical termination of pregnancy was a risk factor for the diagnosis of IUAs. These results suggest that trauma to a recently pregnant uterus is an important risk factor for IUAs.
    CONCLUSIONS: IUA is rare after induced termination of pregnancy (iTOP), but surgical evacuation is a risk factor for IUAs.
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  • 文章类型: Journal Article
    OBJECTIVE: To compare expulsions and adverse events (AEs) between immediate and delayed insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) following medical termination of pregnancy (MTOP).
    METHODS: Randomised controlled trial.
    METHODS: Helsinki University Hospital, Finland, January 2013-December 2014.
    METHODS: Cohorts of 102 (gestational age 64-84 days, late first trimester) and 57 (gestational age 85-140 days, second trimester) women requesting MTOP and LNG-IUS contraception.
    METHODS: LNG-IUS insertion occurred immediately (same day) or 2-4 weeks following MTOP. Follow-up visits were at 2-4 weeks, 3 months, and 1 year.
    METHODS: LNG-IUS expulsion by 3 months and 1 year. AEs and bleeding profiles within 3 months.
    RESULTS: Following late first-trimester MTOP the LNG-IUS expulsion rates by 3 months were 14 (27.5%) in the immediate-insertion group and two (4.0%) in the delayed-insertion group (risk ratio, RR 6.86; 95% confidence interval, 95% CI 1.64-28.66). By 1 year the expulsion rates were 17 (33.3%) and six (12.0%) (RR 2.78, 95% CI 1.19-6.47). Following second-trimester MTOP LNG-IUS expulsion rates by 3 months and 1 year were five (18.5%) in the immediate-insertion group and one (3.6%) in the delayed-insertion group (RR 5.19, 95% CI 0.65-41.54). No differences in AEs and bleeding profiles emerged between the groups.
    CONCLUSIONS: Immediate LNG-IUS insertion after late first- or second-trimester MTOP is feasible, does not increase the complication rate, or alter the uterine bleeding patterns; however, immediate insertion increased the expulsion rate, which may limit the cost-effectiveness.
    CONCLUSIONS: Immediate insertion of LNG-IUS following MTOP at 9-20 weeks of gestation is feasible and safe.
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