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    題名: Effect of Previous Live Birth and Prior Route of Delivery on the Outcome of Early Medical Abortion
    作者: Li-Wei Chien;Wei-Min Liu;Chii-Ruey Tzeng;Heng-Kien Au
    關鍵詞: Obstetrics;Gynecology;Induced abortion;Early;Prognosis;Delivery;Birth
    日期: 2009-03
    上傳時間: 2010-05-12 10:54:12 (UTC+8)
    摘要: OBJECTIVE: To determine the association between type
    of previous delivery (vaginal compared with cesarean) on
    the success of medical abortion with mifepristone–misoprostol
    in early pregnancy.
    METHODS: The records of 879 women with intrauterine
    pregnancies at or before 56 days of gestation who underwent
    medical abortions were reviewed. Medical
    treatment consisted of 600 mg mifepristone orally followed
    48 hours later with oral misoprostol. An ultrasound
    examination was performed 14–21 days after treatment,
    and a successful medical abortion was defined as an
    empty uterus without surgical intervention. Univariable
    and multivariable logistic regressions were used to determine
    risk factors for failure of medical abortion.
    RESULTS: A total of 797 (90.7%) women had successful
    medical abortions; 82 (9.3%) had failed medical abortions.
    Multivariable logistic regression indicated that
    women with gestational ages greater than 42 days (odds
    ratio [OR] 2.53, 95% confidence interval [CI] 1.55– 4.05)
    had higher odds of failed abortion compared with a
    gestational age less than 43 days. Parous women
    (OR>3.94, 95% CI 1.83– 8.53) and those with prior cesarean
    delivery (OR 9.59, 95% CI 4.30 –21.39) were more
    likely to have failed abortions compared with nulliparous
    women. Among 523 parous women (68 had failed abortion),
    those with gestational ages greater than 42 days
    (OR 2.07, 95% CI 1.22–3.50) and prior cesarean delivery
    (OR 3.33, 95% CI 1.95–5.69) were more likely to have
    failed abortions compared with those with gestational
    ages less than 43 days or with prior vaginal delivery.
    CONCLUSION: Parous women are at increased risk for
    failed medical abortion in comparison with nulliparous
    women. Prior cesarean delivery is significantly associated
    with failed medical abortion.
    關聯: The American College of Obstetricians and Gynecologists.113(3):669-674.
    顯示於類別:[婦產部] 期刊論文
    [婦產學科] 期刊論文

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