藥物流產

藥物流產(英語:medical abortion,也稱為藥物墮胎(英語:medication abortion,non-surgical abortion),是指使用藥物進行流產[1],是子宮抽吸或擴張和清宮等手術流產的替代方法。[2][3][1]藥物流產在大多數地方都較為常見,包括歐洲、印度、中國大陸和美國等。[4] [5]

典型的建議是使用兩種藥物,先用米非司酮,再用米索前列醇[3]儘管還有其他選擇,當沒有米非司酮時,可以單獨使用米索前列醇[3] [2]妊娠初期,可以安全地在家中服用這些藥物。[1]妊娠中期,建議在醫院內使用。[3]

藥物流產在各個孕周內都是安全有效的,包括妊娠中期(13至24周)。[3]有部分證據支持在妊娠晚期使用。[6]副作用通常包括陰道出血子宮痙攣噁心和腹瀉。[2]它對精神健康問題乳腺癌不孕症的風險不造成影響。[1]在美國,母親的死亡率比分娩死亡率低14倍;需要住院、輸血或手術的人數不到千分之四。[7]

藥物流產於20世紀70年代開始使用。[2]2020年,美國進行了超過50萬次藥物流產。[8]世界衛生組織建議所有婦女和女孩都能獲得藥物流產,以減少不安全墮胎及其導致的死亡率。[9]截至2023年,在美國這些藥物的成本可能超過500美元;儘管一些慈善機構可能會免費或以低成本提供這些藥物。[10] [11] [12]在加拿大,加拿大人可以享受醫療保險。 [13]截至2018年,在中低收入國家,費用從4美元到36美元不等。[14]藥物流產不應與緊急避孕藥(事後避孕藥)混淆,後者是在性交後不久立即服用以防止懷孕。[15]

參考

  1. ^ 1.0 1.1 1.2 1.3 Macnaughton, H; Nothnagle, M; Early, J. Mifepristone and Misoprostol for Early Pregnancy Loss and Medication Abortion.. American family physician. 2021-04-15, 103 (8): 473-480 [2023-12-06]. PMID 33856168. (原始內容存檔於2023-10-19). 
  2. ^ 2.0 2.1 2.2 2.3 Zhang J, Zhou K, Shan D, Luo X. Medical methods for first trimester abortion. The Cochrane Database of Systematic Reviews. May 2022, 2022 (5): CD002855. PMC 9128719 . PMID 35608608. doi:10.1002/14651858.CD002855.pub5. 
  3. ^ 3.0 3.1 3.2 3.3 3.4 Gemzell-Danielsson, K; Lalitkumar, S. Second trimester medical abortion with mifepristone-misoprostol and misoprostol alone: a review of methods and management.. Reproductive health matters. May 2008, 16 (31 Suppl): 162-72. PMID 18772097. doi:10.1016/S0968-8080(08)31371-8. 
  4. ^ Kapp N, von Hertzen H. Medical methods to induce abortion in the second trimester. Oxford: Wiley-Blackwell. 2009: 178–192. ISBN 978-1-4051-7696-5. 
  5. ^ Jones RK. Medication Abortion Now Accounts for More Than Half of All US Abortions. Guttmacher Institute. 2022-12-01 [2023-04-16]. (原始內容存檔於2022-05-10). 
  6. ^ Vlad S, Boucoiran I, St-Pierre ÉR, Ferreira E. Mifepristone-Misoprostol Use for Second- and Third-Trimester Medical Termination of Pregnancy in a Canadian Tertiary Care Centre. Journal of Obstetrics and Gynaecology Canada. June 2022, 44 (6): 683–689. PMID 35114381. S2CID 246505706. doi:10.1016/j.jogc.2021.12.010. 
  7. ^ Analysis of Medication Abortion Risk and the FDA report - "Mifepristone U.S. Post-Marketing Adverse Events Summary through 12/31/2018" (PDF). Bixby Center for Global Reproductive Health. 2019-04-01 [2023-08-18]. (原始內容存檔 (PDF)於2023-05-16). The mortality rate for women known to have had a live-born infant is 8.8 per 100,000 live births, which is about 14 times higher than the mortality rate associated with medication abortion. 
  8. ^ Rabin RC. Some Women 'Self-Manage' Abortions as Access Recedes - Information and medications needed to end a pregnancy are increasingly available outside the health care system.. The New York Times. 2022-08-07 [2023-08-18]. (原始內容存檔於2022-09-05). More than half a million women had medication abortions in 2020 in the United States, and fewer than half of 1 percent experience serious complications, studies show. Medical interventions like hospitalizations or blood transfusions were needed by fewer than 0.4 percent of patients, according to a 2013 review of dozens of studies involving tens of thousands of patients. 
  9. ^ WHO issues new guidelines on abortion to help countries deliver lifesaving care. www.who.int. [2023-12-07]. (原始內容存檔於2023-11-27) (英語). 
  10. ^ McCann, Allison. Inside the Online Market for Overseas Abortion Pills. The New York Times. 2023-04-13 [2023-12-06]. (原始內容存檔於2023-10-30). 
  11. ^ How Much Do Abortion Pills Cost?. GoodRx. [2023-09-10]. 
  12. ^ How much does the abortion pill cost?. www.plannedparenthood.org. [2023-09-10]. (原始內容存檔於2023-09-07) (英語). 
  13. ^ FAQ: The Abortion Pill Mifegymiso | Action Canada for Sexual Health and Rights. www.actioncanadashr.org. [2023-12-06]. (原始內容存檔於2023-05-28). 
  14. ^ Durocher, J; Kilfedder, C; Frye, LJ; Winikoff, B; Srinivasan, K. A descriptive analysis of medical abortion commodity availability and pricing at retail outlets in 44 countries across four regions globally.. Sexual and reproductive health matters. December 2021, 29 (1): 1982460. PMID 34719353. doi:10.1080/26410397.2021.1982460. 
  15. ^ The Difference Between the Morning-After Pill and the Abortion Pill (PDF). Planned Parenthood. [2023-12-07]. (原始內容存檔 (PDF)於2023-09-13).