Treatment of miscarriage: Current practice and rationale
Treatment of miscarriage: Current practice and rationale
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DOI：
10.1016/s0029-7844(97)00606-6
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发表时间：
1998-02-01
影响因子：
7.2
通讯作者：
Hemminki, E
中科院分区：
文献类型：
--
作者：
Hemminki, E
目的：描述芬兰流产期间的卫生服务使用情况和流产医疗治疗及其背后的原理。方法：治疗实践的描述基于 1994 年对 3000 名 18-44 岁芬兰女性进行的全国代表性样本调查、1988 年和 1995 年国家医院护理登记数据以及医生教科书（1950-1994 年）中的治疗建议，护士和助产士。对通过各种系统检索确定的已发表的对照研究进行了审查，以寻找证明所确定做法合理性的科学证据。结果：根据调查，326 名流产妇女中，97% 曾看过医生，74% 被视为住院患者。医院登记显示，大多数（1988 年至少为 84%，1995 年为 88%）流产的妇女都接受了子宫清宫术。根据教科书的建议，医生护理、住院护理和常规子宫清宫术被视为常态。没有发现为这些做法提供实证支持的对照研究。总体而言，研究较少且较新，并且侧重于不同的清宫方法。结论：目前流产的治疗并非基于对照研究。护理的各个方面，从最好的护理提供者到各种干预措施，都迫切需要通过试验进行进一步评估。 (C) 1998 年，美国妇产科医师学会。）。
Objective: To describe health service use during miscarriage and medical treatment of miscarriage in Finland and the rationales behind them.Methods: Description of the treatment practices was based on a survey sent to a nationally representative sample of 3000 Finnish women age 18-44 years in 1994, on national hospital care register data from 1988 and 1995, and on treatment recommendations in textbooks (from 1950-1994) for physicians, nurses, and midwives. Published, controlled studies that were identified through various systematic searches were reviewed for scientific evidence justifying the identified practices.Results: According to the survey, 97% of the 326 women who had a miscarriage had visited a physician, and 74% were treated as inpatients. The hospital registers indicated that most (at least 84% in 1988, and 88% in 1995) women who had a miscarriage had their uteri evacuated operatively. According to the textbook recommendation, care by a physician, inpatient care, and routine uterine evacuations were seen as norms. No controlled studies providing empirical support for these practices were found. In general, studies were few and recent, and they placed emphasis on different evacuation methods.Conclusion: Current treatment of miscarriage is not based on controlled studies. All aspects of care, from best care provider to various interventions, urgently need further evaluation by trials. (C) 1998 by The American College of Obstetricians and Gynecologists.).