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[PMID]:29384854
[Au] Autor:Gao J; Li X; Chen J; Gong W; Yue K; Wu Z
[Ad] Endereço:Department of Interventional Radiology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China.
[Ti] Título:Uterine artery embolization combined with local infusion of methotrexate and 5- fluorouracil in treating ectopic pregnancy: A CONSORT-compliant article.
[So] Source:Medicine (Baltimore);97(5):e9722, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To compare the efficiency and safety of uterine artery embolization (UAE) combined with local infusion of methotrexate (MTX) or MTX and 5-fluorouracil (5-FU) in the treatment of ectopic pregnancy (EP). METHODS: One hundred women with EP were prospectively enrolled from December 2012 to February 2015 and randomly allocated into 2 groups. One group was treated with UAE combined MTX, and the other with UAE combined with MTX and 5-FU. Local MTX was administrated at a dose of 80 to 120 mg, based on the initial ß-human chorionic gonadotropin (ß-HCG) levels, and 5-FU was given intra-arterially at a uniform dose of 0.5 g. RESULTS: Bilateral UAE was successfully performed in all 100 patients, 88 of whom were clinically successfully treated, 45 (91.8%) in the MTX group, and 43 (87.8%) in the MTX + 5-FU group; 89% of the patients achieved normalization of ß-HCG below 70,000 mIU/mL within 14 to 21 days postoperatively. The time to successful ß-HCG resolution was 26.74 ±â€Š5.57 days for patients receiving MTX + UAE treatment, and 27.57 ±â€Š5.08 days for those treated with additional 5-FU. Six patients had subsequent intramuscular injections of MTX and 6 had a unilateral salpingectomy after the treatment failure. Mild immediate side effects accounted for 24.5% in the sole MTX and 58.3% in MTX + 5-FU group. CONCLUSION: A combination of UAE and intrauterine infusion of MTX showed comparable efficiency to UAE combined with a local infusion of MTX and 5-FU in treating EP patients with the intention to preserve fertility.
[Mh] Termos MeSH primário: Abortivos/uso terapêutico
Fluoruracila/administração & dosagem
Metotrexato/administração & dosagem
Gravidez Ectópica/tratamento farmacológico
Gravidez Ectópica/cirurgia
Embolização da Artéria Uterina
[Mh] Termos MeSH secundário: Adulto
Antimetabólitos/uso terapêutico
Gonadotropina Coriônica/metabolismo
Terapia Combinada
Feminino
Antagonistas do Ácido Fólico/uso terapêutico
Seres Humanos
Injeções Intra-Arteriais
Gravidez
Gravidez Ectópica/metabolismo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Abortifacient Agents); 0 (Antimetabolites); 0 (Chorionic Gonadotropin); 0 (Folic Acid Antagonists); U3P01618RT (Fluorouracil); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009722


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[PMID]:28385872
[Au] Autor:Vogel L
[Ad] Endereço:CMAJ.
[Ti] Título:Doctors, pharmacists push back on medical abortion rules.
[So] Source:CMAJ;189(12):E480-E481, 2017 03 27.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Aborto Induzido
Órgãos Governamentais
Política de Saúde
Farmacêuticos
Médicos
[Mh] Termos MeSH secundário: Abortivos/uso terapêutico
Confidencialidade
Seres Humanos
Mifepristona/uso terapêutico
Misoprostol/uso terapêutico
[Pt] Tipo de publicação:NEWS
[Nm] Nome de substância:
0 (Abortifacient Agents); 0E43V0BB57 (Misoprostol); 320T6RNW1F (Mifepristone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.1095406


  3 / 1525 MEDLINE  
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[PMID]:28277622
[Au] Autor:Zheng N; Chen J; Li T; Liu W; Liu J; Chen H; Wang J; Jia L
[Ad] Endereço:Cancer Metastasis Alert and Prevention Center, and Biopharmaceutical Photocatalysis of State Key Laboratory of Photocatalysis on Energy and Environment, Fuzhou University, Fuzhou, China.
[Ti] Título:Abortifacient metapristone (RU486 derivative) interrupts CXCL12/CXCR4 axis for ovarian metastatic chemoprevention.
[So] Source:Mol Carcinog;56(8):1896-1908, 2017 Aug.
[Is] ISSN:1098-2744
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent global epidemiological studies revealed the lower ovarian cancer death from long-term use of oral contraceptives. However, the underlying mechanism of action is not clear. Here, we use the abortifacient metapristone (RU486 derivative) to test the hypothesis that the contraceptives might interrupt CXCL12/CXCR4 chemokine axis to inhibit ovarian cancer metastasis. Metapristone at concentrations (
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Quimiocina CXCL12/metabolismo
Mifepristona/análogos & derivados
Invasividade Neoplásica/prevenção & controle
Neoplasias Epiteliais e Glandulares/patologia
Neoplasias Ovarianas/patologia
Neoplasias Peritoneais/prevenção & controle
Neoplasias Peritoneais/secundário
Receptores CXCR4/metabolismo
[Mh] Termos MeSH secundário: Abortivos/química
Abortivos/farmacologia
Abortivos/uso terapêutico
Animais
Antineoplásicos/química
Antineoplásicos/farmacologia
Adesão Celular/efeitos dos fármacos
Linhagem Celular Tumoral
Movimento Celular/efeitos dos fármacos
Proliferação Celular/efeitos dos fármacos
Quimioprevenção
Feminino
Seres Humanos
Camundongos Endogâmicos BALB C
Camundongos Nus
Mifepristona/química
Mifepristona/farmacologia
Mifepristona/uso terapêutico
Invasividade Neoplásica/patologia
Neoplasias Epiteliais e Glandulares/tratamento farmacológico
Neoplasias Epiteliais e Glandulares/metabolismo
Neoplasias Ovarianas/tratamento farmacológico
Neoplasias Ovarianas/metabolismo
Ovário/efeitos dos fármacos
Ovário/metabolismo
Ovário/patologia
Neoplasias Peritoneais/metabolismo
Neoplasias Peritoneais/patologia
Peritônio/efeitos dos fármacos
Peritônio/metabolismo
Peritônio/patologia
Transdução de Sinais/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Abortifacient Agents); 0 (Antineoplastic Agents); 0 (CXCL12 protein, human); 0 (CXCR4 protein, human); 0 (Chemokine CXCL12); 0 (Receptors, CXCR4); 320T6RNW1F (Mifepristone); K1P8OGJ86J (metapristone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1002/mc.22645


  4 / 1525 MEDLINE  
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[PMID]:28148487
[Au] Autor:Dyer C
[Ad] Endereço:The BMJ.
[Ti] Título:Mother wins right to challenge prosecution for buying abortion pills in Northern Ireland.
[So] Source:BMJ;356:j527, 2017 Feb 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Aborto Criminoso/legislação & jurisprudência
Direitos Humanos/legislação & jurisprudência
Mães/legislação & jurisprudência
Gravidez na Adolescência
[Mh] Termos MeSH secundário: Abortivos
Adolescente
Feminino
Seres Humanos
Internet
Irlanda do Norte
Gravidez
[Pt] Tipo de publicação:NEWS
[Nm] Nome de substância:
0 (Abortifacient Agents)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j527


  5 / 1525 MEDLINE  
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[PMID]:28073735
[Au] Autor:Carlsson T; Axelsson O
[Ad] Endereço:Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
[Ti] Título:Patient Information Websites About Medically Induced Second-Trimester Abortions: A Descriptive Study of Quality, Suitability, and Issues.
[So] Source:J Med Internet Res;19(1):e8, 2017 Jan 10.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients undergoing medically induced second-trimester abortions feel insufficiently informed and use the Web for supplemental information. However, it is still unclear how people who have experience with pregnancy termination appraise the quality of patient information websites about medically induced second-trimester abortions, whether they consider the websites suitable for patients, and what issues they experience with the websites. OBJECTIVE: Our objective was to investigate the quality of, suitability of, and issues with patient information websites about medically induced second-trimester abortions and potential differences between websites affiliated with the health care system and private organizations. METHODS: We set out to answer the objective by using 4 laypeople who had experience with pregnancy termination as quality assessors. The first 50 hits of 26 systematic searches were screened (N=1300 hits) using search terms reported by the assessors. Of these hits, 48% (628/1300) were irrelevant and 51% (667/1300) led to websites about medically induced second-trimester abortions. After correcting for duplicate hits, 42 patient information websites were included, 18 of which were affiliated with the health care system and 24 with private organizations. The 4 assessors systematically assessed the websites with the DISCERN instrument (total score range 16-80), the Ensuring Quality Information for Patients (EQIP) tool (total score range 0-100), as well as questions concerning website suitability and perceived issues. RESULTS: The interrater reliability was 0.8 for DISCERN and EQIP, indicating substantial agreement between the assessors. The total mean score was 36 for DISCERN and 40 for EQIP, indicating poor overall quality. Websites from the health care system had greater total EQIP (45 vs 37, P>.05) and reliability scores (22 vs 20, P>.05). Only 1 website was recommended by all assessors and 57% (24/42) were rated as very unsuitable by at least one assessor. The most reported issues with the websites involved lack of information (76%, 32/42), and poor design (36%, 15/42). CONCLUSIONS: The high number of irrelevant hits and poor quality of patient information websites are considerable issues that must be addressed and considered when consulting patients awaiting medically induced second-trimester abortions. In clinical encounters, health professionals should initiate discussions concerning websites about medically induced second-trimester abortions and inform patients about the issues and quality deficits associated with these websites.
[Mh] Termos MeSH primário: Aborto Induzido/educação
Informação de Saúde ao Consumidor/métodos
Internet
Educação de Pacientes como Assunto/métodos
[Mh] Termos MeSH secundário: Abortivos
Aborto Induzido/métodos
Informação de Saúde ao Consumidor/normas
Feminino
Seres Humanos
Educação de Pacientes como Assunto/normas
Gravidez
Segundo Trimestre da Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Abortifacient Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170112
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.6380


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[PMID]:28025018
[Au] Autor:Gonsalves L; Hindin MJ
[Ad] Endereço:Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland. Electronic address: gonsalvesl@who.int.
[Ti] Título:Pharmacy provision of sexual and reproductive health commodities to young people: a systematic literature review and synthesis of the evidence.
[So] Source:Contraception;95(4):339-363, 2017 Apr.
[Is] ISSN:1879-0518
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We conducted a systematic review of peer-reviewed literature on youth access to, use of and quality of care of sexual and reproductive health (SRH) commodities through pharmacies. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we searched for publications from 2000 to 2016. To be eligible for inclusion, articles had to address the experiences of young people (aged 25 years and below) accessing SRH commodities (e.g., contraception, abortifacients) via pharmacies. The heterogeneity of the studies precluded meta-analysis - instead, we conducted thematic analysis. RESULTS: A total of 2842 titles were screened, and 49 met the inclusion criteria. Most (n=43) were from high-income countries, and 33 examined emergency hormonal contraception provision. Seventeen focused on experiences of pharmacy personnel in provision, while 28 assessed client experiences. Pharmacy provision of SRH commodities was appealing to and utilized by youth. Increasing access to SRH commodities for youth did not correspond to increases in risky sexual behavior. Both pharmacists and youth had reservations about the ease of access and its impact on sexual behaviors. In settings where regulations allowing pharmacy access were established, some pharmacy personnel created barriers to access or refused access entirely. DISCUSSION: With training and support, pharmacy personnel can serve as critical SRH resources to young people. Further research is needed to better understand how to capitalize on the potential of pharmacy provision of SRH commodities to young people without sacrificing qualities which make pharmacies so appealing to young people in the first place.
[Mh] Termos MeSH primário: Abortivos/provisão & distribuição
Anticoncepcionais Pós-Coito/provisão & distribuição
Acesso aos Serviços de Saúde
Farmácias
Kit de Reagentes para Diagnóstico/provisão & distribuição
[Mh] Termos MeSH secundário: Adolescente
Atitude do Pessoal de Saúde
Anticoncepcionais/provisão & distribuição
Feminino
Seres Humanos
Masculino
Saúde Reprodutiva
Doenças Sexualmente Transmissíveis/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Abortifacient Agents); 0 (Contraceptive Agents); 0 (Contraceptives, Postcoital); 0 (Reagent Kits, Diagnostic)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161228
[St] Status:MEDLINE


  7 / 1525 MEDLINE  
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[PMID]:27871191
[Au] Autor:Louie KS; Chong E; Tsereteli T; Avagyan G; Abrahamyan R; Winikoff B
[Ad] Endereço:a Gynuity Health Projects , New York , NY , USA.
[Ti] Título:Second trimester medical abortion with mifepristone followed by unlimited dosing of buccal misoprostol in Armenia.
[So] Source:Eur J Contracept Reprod Health Care;22(1):76-80, 2017 Feb.
[Is] ISSN:1473-0782
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of the study was to assess the efficacy and acceptability of a regimen using mifepristone and buccal misoprostol with unlimited dosing for second trimester abortion in Armenia. METHODS: Women seeking to terminate 13-22 week pregnancies were enrolled in the study. Participants swallowed 200 mg mifepristone in the clinic and were instructed to return to the hospital for induction 24-48 h later. During induction, women were given 400 µg buccal misoprostol every 3 h until the fetus and placenta were expelled. The abortion was considered a success if complete uterine evacuation was achieved without oxytocin or surgery. RESULTS: A total of 120 women with a median gestational age of 18 weeks participated in the study. All women began misoprostol induction around 24 h after taking mifepristone. Complete uterine evacuation was achieved in 119 (99.2%) women. The median induction-to-abortion interval was 10.3 h (range 4-17.4) with a mean of 9.5 ± 2.5 h. A median of four misoprostol doses (range 2-6) with a mean of 4 ± 1 misoprostol doses were administered. The induction-to-abortion interval, number of misoprostol doses, pain score and analgesia use increased as gestational age advanced. Acceptability of the method was high among both patients and providers. CONCLUSION: The medical abortion regimen of 200 mg mifepristone followed 24 h later by induction with 400 µg buccal misoprostol administered every 3 h, with no limit on the number of doses used for the termination of pregnancies of 13-22 weeks' gestation is an effective and acceptable option for women.
[Mh] Termos MeSH primário: Abortivos/administração & dosagem
Aborto Induzido/métodos
Mifepristona/administração & dosagem
Misoprostol/administração & dosagem
Segundo Trimestre da Gravidez
[Mh] Termos MeSH secundário: Administração Bucal
Adulto
Armênia
Esquema de Medicação
Feminino
Idade Gestacional
Seres Humanos
Gravidez
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Abortifacient Agents); 0E43V0BB57 (Misoprostol); 320T6RNW1F (Mifepristone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170616
[Lr] Data última revisão:
170616
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161123
[St] Status:MEDLINE
[do] DOI:10.1080/13625187.2016.1258461


  8 / 1525 MEDLINE  
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[PMID]:27865408
[Au] Autor:García Mitacek MC; Bonaura MC; Praderio RG; Nuñez Favre R; de la Sota RL; Stornelli MA
[Ad] Endereço:Catedra y Servicio de Reproducción Animal, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, La Plata, Argentina; CONICET, CABA, Capital Federal, Argentina.
[Ti] Título:Progesterone and ultrasonographic changes during aglepristone or cloprosternol treatment in queens at 21 to 22 or 35 to 38 days of pregnancy.
[So] Source:Theriogenology;88:106-117, 2017 Jan 15.
[Is] ISSN:1879-3231
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Progesterone (P ) is a requirement for pregnancy development. Previous reports observed a maximal value of serum P concentration on 21 days after the first mating after which it slowly declines throughout the rest of pregnancy. Ultrasound examination should be performed to ensure that pregnancy interruption is complete. Limited information is available on the ultrasonic appearance of conceptuses during pregnancy termination in cats The objective was to study serum P concentration and ultrasonographic changes during aglepristone (ALI) or cloprostenol (CLO) treatment and to evaluate the fertility after treatment. Two experiments (EXP) were carried out to accomplish this aim. Sixty queens, 12- to 36-month-old, were used. On Days 21 to 22 of pregnancy (EXP I) or 35 to 38 of pregnancy (EXP II), queens were divided into three groups (G). Queens in G1 received ALI (10 mg/kg, sc; EXP I, n = 10; EXP II, n = 10) for 2 consecutive days. Queens in G2 received CLO (5 µg/kg, sc; EXP I, n = 10; EXP II = 10) for 3 consecutive days. Queens in G3 received 1 mL of saline solution (PLA, sc; EXP I, n = 10; EXP II = 10). Blood samples were taken before treatment (Day 0) and every day during 10 days after the treatment to measure serum P concentrations. Likewise, after treatment, queens were monitored daily by ultrasonography for 10 days and weekly until the end of gestation to obtain gestational sacs measurements (GS), fetal measurements, and fetal biophysical profile. Data were analyzed by ANOVA. Serum P concentrations were significantly different on Day 6 (EXP I) and on Day 1 (EXP II) in ALI and CLO groups compared with PLA group (P < 0.05 and P < 0.01; respectively). The ultrasonographic monitoring during treatment allowed assessing changes in the GS and fetal measurements, embryo-fetal viability, and risk of pregnancy loss. In conclusion, the results from this study reported changes in serum P concentration and in ultrasonography measurements during pregnancy interruption with ALI or CLO treatment. Also it was observed that ALI and CLO are safe drugs and can preserve posttreatment queen fertility. Therefore, the results obtained in our work will be applied in feline reproduction practice.
[Mh] Termos MeSH primário: Cloprostenol/farmacologia
Estrenos/farmacologia
Progesterona/metabolismo
Ultrassonografia Pré-Natal/veterinária
[Mh] Termos MeSH secundário: Abortivos/farmacologia
Aborto Animal/induzido quimicamente
Animais
Gatos
Feminino
Fertilidade/efeitos dos fármacos
Luteolíticos/farmacologia
Masculino
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Abortifacient Agents); 0 (Estrenes); 0 (Luteolytic Agents); 0UT4JLE1CM (aglepristone); 4208238832 (Cloprostenol); 4G7DS2Q64Y (Progesterone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170512
[Lr] Data última revisão:
170512
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE


  9 / 1525 MEDLINE  
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[PMID]:27678099
[Au] Autor:Li CL; Song LP; Tang SY; Zhou LJGY; He H; Mo XT; Liao YM
[Ad] Endereço:1 Key Laboratory for Reproduction and Genetics of Guangdong Higher-Education Institutes and Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital, Guangzhou Institute of Obstetrics and Gynecology, Guangzhou Medical University, Guangzhou, People's Republic o
[Ti] Título:Efficacy, Safety, and Acceptability of Low-Dose Mifepristone and Self-Administered Misoprostol for Ultra-Early Medical Abortion: A Randomized Controlled Trial.
[So] Source:Reprod Sci;24(5):731-737, 2017 May.
[Is] ISSN:1933-7205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to investigate the efficacy, safety, and acceptability of low-dose mifepristone combined with self-administered misoprostol for ultra-early medical abortion. A total of 744 women with ultra-early pregnancy (amenorrhea ≤35 days) who fulfilled the inclusion criteria were enrolled in the study. Equal numbers of participants were allocated randomly to the hospital administration and self-administration groups. All participants took 75 mg mifepristone at the initial visit and 400 µg oral misoprostol 24 hours later in the hospital or by self-administration. The primary end point was complete abortion. Secondary end points were rates of unscheduled reattendance, time required for and cost of hospital observation and follow-up, vaginal bleeding, adverse effects, menstrual disturbance in the posttreatment period, and satisfaction rating. No differences in the rates of complete abortion, unscheduled reattendance, vaginal bleeding, adverse effects, or return of posttreatment menstruation were observed. The time required for (and costs of) hospital observation and follow-up per participant was 557.82 minutes (and US$40.12) in the hospital administration group and 18.46 minutes (and US$1.96) in the self-administration group (both P < .001). Satisfaction rates were similar in both groups, but the rates of "very satisfied" responses (87.60% vs 25.41%) and follow-up compliance (loss to follow-up, 0.45% vs 7.70%) were higher in the self-administration group (both P < .001). Low-dose mifepristone combined with self-administered misoprostol for ultra-early pregnancy termination was as effective and safe as hospital administration, with greater acceptability and lower cost to the women.
[Mh] Termos MeSH primário: Abortivos/administração & dosagem
Aborto Induzido/métodos
Mifepristona/administração & dosagem
Misoprostol/administração & dosagem
[Mh] Termos MeSH secundário: Abortivos/efeitos adversos
Administração Oral
Adulto
Quimioterapia Combinada
Feminino
Seres Humanos
Mifepristona/efeitos adversos
Misoprostol/efeitos adversos
Gravidez
Primeiro Trimestre da Gravidez
Autoadministração
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Abortifacient Agents); 0E43V0BB57 (Misoprostol); 320T6RNW1F (Mifepristone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170505
[Lr] Data última revisão:
170505
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160929
[St] Status:MEDLINE
[do] DOI:10.1177/1933719116669055


  10 / 1525 MEDLINE  
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[PMID]:27824749
[Au] Autor:Schreiber CA; Chavez V; Whittaker PG; Ratcliffe SJ; Easley E; Barg FK
[Ad] Endereço:Penn Family Planning and Pregnancy Loss Center, Department of Obstetrics and Gynecology, the Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, and the Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
[Ti] Título:Treatment Decisions at the Time of Miscarriage Diagnosis.
[So] Source:Obstet Gynecol;128(6):1347-1356, 2016 Dec.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the factors patients and physicians prioritize during first-trimester miscarriage management and assess what drives satisfaction with care. METHODS: We conducted a mixed-methods study of clinically stable women seeking surgical, medical, or expectant miscarriage treatment. Women with first-trimester fetal demise or anembryonic gestation (N=55) completed demographic and psychosocial surveys. Using purposive sampling, 45 (82%) completed in-depth interviews. Fifteen obstetricians were interviewed. Participants described factors that informed their counseling (physicians) or decision-making (patients). Content analysis used an integrated approach with inductively and deductively derived codes. Patient-derived themes were stratified by treatment choice. Associations between variables and treatment choices were analyzed. RESULTS: Thirty-four women (62%) received surgical management, 19 (35%) received medical, and two (4%) received expectant. Physicians expected that women with prior pregnancies have strong management preferences, and indeed, multigravid patients were less likely to change their initial treatment choice after counseling than primigravid patients (12% compared with 42%, odds ratio [OR] 0.18, 95% confidence interval [CI] 0.04-0.81, P=.03). Physicians favored patient-centered decisions and patients chose the treatment that they thought would least affect other responsibilities. Those ultimately receiving surgical management had a higher monthly income (adjusted OR 1.30, 95% CI 1.04-1.63, P=.023) and more social support (adjusted OR 2.45, 95% CI 1.07-5.61, P=.035) than the medical group. The surgical group cited loss acceptance, a favorable perception of surgery, and a desire to expedite the miscarriage as decisive factors. The medical group endorsed control over, and timed completion of, the miscarriage in a more intimate setting, an aversion to surgery or anesthesia, and a perception of improved fertility preservation as decisive factors. Regardless of treatment choice, satisfaction with treatment was linked to a supportive clinical team and expeditious resolution. CONCLUSION: Prior pregnancy experiences, obligations, and sociodemographic factors influence miscarriage management decision-making. Structured counseling, especially for primigravid patients, could improve both the physician and the patient experience with miscarriage care.
[Mh] Termos MeSH primário: Aborto Espontâneo/psicologia
Aborto Espontâneo/terapia
Comportamento de Escolha
Aconselhamento Diretivo/métodos
Participação do Paciente
Satisfação do Paciente
[Mh] Termos MeSH secundário: Abortivos/uso terapêutico
Aborto Espontâneo/diagnóstico
Aborto Terapêutico
Adolescente
Adulto
Feminino
Número de Gestações
Seres Humanos
Renda
Entrevistas como Assunto
Masculino
Meia-Idade
Padrões de Prática Médica
Gravidez
Primeiro Trimestre da Gravidez
Apoio Social
Inquéritos e Questionários
Conduta Expectante
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Abortifacient Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161109
[St] Status:MEDLINE



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