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药物流产

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药物流产（英語：medical abortion，也称为药物堕胎（英語：medication abortion，non-surgical abortion），是指使用药物进行流产[1]，是子宫抽吸或扩张和清宫等手术流产的替代方法。[2][3][1]药物流产在大多数地方都较为常见，包括欧洲、印度、中国大陸和美国等。[4] [5]

典型的建议是使用两种药物，先用米非司酮，再用米索前列醇。[3]尽管还有其他选择，当没有米非司酮时，可以单独使用米索前列醇。[3] [2]在妊娠初期，可以安全地在家中服用这些药物。[1]在妊娠中期，建议在医院内使用。[3]

药物流产在各个孕周内都是安全有效的，包括妊娠中期（13至24周）。[3]有部分证据支持在妊娠晚期使用。[6]副作用通常包括阴道出血，子宫痉挛，恶心和腹泻。[2]它对精神健康问题、乳腺癌或不孕症的风险不造成影响。[1]在美国，母亲的死亡率比分娩死亡率低14倍；需要住院、输血或手术的人数不到千分之四。[7]

药物流产于20世纪70年代开始使用。[2]2020年，美国进行了超过50万次药物流产。[8]世界卫生组织建议所有妇女和女孩都能获得药物流产，以减少不安全堕胎及其导致的死亡率。[9]截至2023年，在美国这些药物的成本可能超过500美元；尽管一些慈善机构可能会免费或以低成本提供这些药物。[10] [11] [12]在加拿大，加拿大人可以享受医疗保险。 [13]截至2018年，在中低收入国家，费用从4美元到36美元不等。[14]药物流产不应与紧急避孕药（事后避孕药）混淆，后者是在性交后不久立即服用以防止怀孕。[15]

参考

  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. （原始内容存档于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 可免费查阅. 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]. （原始内容存档于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]. （原始内容存档 (PDF)于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]. （原始内容存档于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]. （原始内容存档于2023-11-27） （英语）. 
  10. ^ McCann, Allison. Inside the Online Market for Overseas Abortion Pills. The New York Times. 2023-04-13 [2023-12-06]. （原始内容存档于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]. （原始内容存档于2023-09-07） （英语）. 
  13. ^ FAQ: The Abortion Pill Mifegymiso | Action Canada for Sexual Health and Rights. www.actioncanadashr.org. [2023-12-06]. （原始内容存档于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]. （原始内容存档 (PDF)于2023-09-13）. 
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