Alternatives to routine ultrasound for eligibility assessment prior to early termination of pregnancy with mifepristone-misoprostol
Alternatives to routine ultrasound for eligibility assessment prior to early termination of pregnancy with mifepristone-misoprostol
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DOI：
10.1111/j.1471-0528.2010.02753.x
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发表时间：
2011-01-01
影响因子：
5.8
通讯作者：
Winikoff, B.
中科院分区：
文献类型：
--
作者：
Bracken, H.;Clark, W.;Winikoff, B.
目的测试的可行性和有效性的方法，放弃常规使用超声波的医疗终止妊娠的合格性的determinationformedicalterminationofpregnancy.DesignProspective trial.SettingTen终止妊娠诊所在美国的populationA共4484妇女寻求终止妊娠与米非司酮-妇女提供估计的日期，他们的最后一次月经期，并进行盆腔双合和超声检查。我们比较了使用这三种方法估计的胎龄。主要结果测量由妇女或提供者估计的< 9周妊娠的妇女比例，结果依靠妇女末次月经报告和体格检查来确定其是否符合米非司酮-米索前列醇终止妊娠的条件，（63/4008或1.6%）接受了用于提前终止妊娠的标准米非司酮-米索前列醇方案当前限度以外的治疗结论仅末次月经和体格检查，不常规使用超声，对于确定妇女是否有资格使用米非司酮-米索前列醇提前终止妊娠非常有效。
ObjectiveTo test the feasibility and efficacy of an approach that foregoes the routine use of ultrasound for the determination of eligibility for medical termination of pregnancy.DesignProspective trial.SettingTen termination of pregnancy clinics in the USA.PopulationA total of 4484 women seeking termination of pregnancy with mifepristone-misoprostol.MethodsWomen provided estimates of the date of their last menstrual period and underwent pelvic bimanual and ultrasound examinations. We compared estimates of gestational age using these three methods.Main outcome measureProportion of women of < 9 weeks' gestation by woman or provider estimate, but > 9 weeks' gestation by ultrasound.ResultsThe reliance on women's report of their last menstrual period together with physical examination to determine their eligibility for termination of pregnancy with mifepristone-misoprostol would result in few women (63/4008 or 1.6%) accepted for treatment outside the current limits of standard mifepristone-misoprostol regimens used for early termination of pregnancy (i.e. < 63 days' gestation on ultrasound).ConclusionsLast menstrual period and physical examination alone, without the routine use of ultrasound, are highly effective for the determination of women's eligibility for early termination of pregnancy with mifepristone-misoprostol.