Induced abortion

被引:35
作者
Cameron, S. [2 ]
Glasier, A. [3 ]
Lohr, P. A. [4 ]
Moreau, C. [5 ,6 ]
Munk-Olssen, T. [7 ]
Oppengaard, K. S. [8 ]
Templeton, A. [9 ]
Van Look, P.
Baird, D. T. [10 ]
Crosignani, P. G. [1 ]
La Vecchia, C. [11 ]
Negri, E. [12 ]
Volpe, A. [13 ]
机构
[1] IRCCS Ca Granda Fdn, Maggiore Policlin Hosp, Via M Fanti 6, I-20122 Milan, Italy
[2] Univ Edinburgh, Chalmers Sexual & Reprod Hlth Serv, Edinburgh, Midlothian, Scotland
[3] Univ Edinburgh, Simpson Ctr Reprod Hlth, Edinburgh, Midlothian, Scotland
[4] British Pregnancy Advisory Serv, Doncaster, England
[5] Hop Kremlin Bicetre, CESP Gender Sexual & Reprod Hlth, Inserm U1018, Le Kremlin Bicetre, France
[6] Johns Hopkins Univ, Dept Populat Family & Reprod Hlth, Bloomberg Sch Publ Hlth, Baltimore, MD USA
[7] Aarhus Univ, Natl Ctr Register Based Res, Aarhus V, Denmark
[8] Innlandet Hosp Trust, Lillehammer, Norway
[9] Univ Aberdeen, Dept Obstet & Gynaecol, Maternal Hosp, Foresterhill, Aberdeen, Scotland
[10] Univ Edinburgh, Ctr Reprod Biol, Edinburgh, Midlothian, Scotland
[11] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy
[12] IRCCS Ist Ric Farmacol Mario Negri, Dept Epidemiol, Milan, Italy
[13] Univ Modena, Dipartimento Integrato Materno Infantile, Modena, Italy
关键词
unintended pregnancy; abortion prevalence; availability; abortion methods; safety; post-abortion care; prevention; MEDICAL ABORTION; SURGICAL ABORTION; 1ST-TRIMESTER ABORTION; ADOLESCENT PREGNANCY; VACUUM ASPIRATION; DELAYED INSERTION; BREAST-CANCER; UNITED-STATES; FOLLOW-UP; TERMINATION;
D O I
10.1093/humrep/dex071
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Abortion is common. Data on abortion rates are inexact but can be used to explore trends. Globally, the estimated rate in the period 2010-2014 was 35 abortions per 1000 women ( aged 15-44 years), five points less than the rate of 40 for the period 1990-1994. Abortion laws vary around the world but are generally more restrictive in developing countries. Restrictive laws do not necessarily deter women from seeking abortion but often lead to unsafe practice with significant mortality and morbidity. While a legal framework for abortion is a prerequisite for availability, many laws, which are not evidence based, restrict availability and delay access. Abortion should be available in the interests of public health and any legal framework should be as permissive as possible in order to promote access. In the absence of legal access, harm reduction strategies are needed to reduce abortion-related mortality and morbidity. Abortion can be performed surgically ( in the first trimester, by manual or electric vacuum aspiration) or with medication: both are safe and effective. Cervical priming facilitates surgery and reduces the risk of incomplete abortion. Diagnosis of incomplete abortion should be made on clinical grounds, not by ultrasound. Septic abortion is a common cause of maternal death almost always following unsafe abortion and thus largely preventable. While routine follow-up after abortion is unnecessary, all women should be offered a contraceptive method immediately after the abortion. This, together with improved education and other interventions, may succeed in reducing unintended pregnancy.
引用
收藏
页码:1160 / 1169
页数:10
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