First-trimester abortion in women with medical conditions
First-trimester abortion in women with medical conditions
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DOI：
10.1016/j.contraception.2012.09.001
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发表时间：
2012-12-01
期刊：
影响因子：
2.9
通讯作者：
Davis, Anne
中科院分区：
文献类型：
--
作者：
Guiahi, Maryam;Davis, Anne
大多数进行妊娠早期流产的妇女都是健康的。然而，堕胎提供者也会遇到患有各种各样疾病的妇女，其中一些是严重和复杂的。如果存在这种情况，与妇女的医生或专科医生进行协商，可以促进就医院转诊和可能需要的其他准备工作作出决定。医疗条件可能决定堕胎的方式。当米非司酮或甲氨蝶呤有禁忌症时，首选手术流产。当取石位置不可能或患者极度肥胖时，可优先选择药物流产。有限的数据表明，接受抗凝治疗的妇女在手术流产期间出血多于其他妇女，尽管这种额外的出血在临床上可能不重要。暂时停止抗凝治疗的决定取决于所使用的药物和潜在的血栓形成风险。根据美国心脏协会的说法，不建议在手术流产过程中有心脏病变的妇女使用额外的抗生素来预防心内膜炎。我们审查了对患有常见疾病的妇女的具体建议。在一些妇女中，高度有效的流产后避孕对于预防妊娠相关疾病至关重要。美国。《2010年避孕药具使用医疗资格标准》为有医疗问题的妇女选择避孕方法提供了指导。(C) 2012爱思唯尔公司版权所有。
Most women undergoing first-trimester abortion are healthy. However, abortion providers also encounter women with a wide variety of medical conditions, some of which are serious and complex. When such a condition exists, consultation with the woman's physician or a specialist can facilitate decision making regarding hospital referral and additional preparations that may be required. Medical conditions may determine the approach to abortion. Surgical abortion is preferred when mifepristone or methotrexate is contraindicated. Medication abortion may be preferred when lithotomy position is not possible or in patients with extreme obesity. Limited data suggest that women treated with anticoagulation therapy bleed more than other women during surgical abortion, although this additional bleeding may be clinically unimportant. The decision to temporarily discontinue anticoagulation therapy will depend on the agent used and the underlying risk of thrombosis. According to the American Heart Association, additional antibiotics are not recommended to prevent endocarditis in women with cardiac lesions during surgical abortion. We review specific recommendations for women with common medical conditions. In some women, highly effective postabortion contraception is essential to prevent pregnancy-related morbidity. The US. Medical Eligibility Criteria for Contraceptive Use, 2010, provides guidance for method selection for women with medical problems. (C) 2012 Elsevier Inc. All rights reserved.