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Obstet Gynecol：醋酸甲羟孕酮注射时间点影响流产效能和再次妊娠风险

2016-10-02 xing.T MedSci原创

醋酸甲羟孕酮
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由此可见，醋酸甲羟孕酮同时给予米非司酮药物流产后没有增加明显的手术风险，但也没有增加继续妊娠的风险。它提高了病人的满意度，但没有发现任何证据表明这样能够降低6个月内再次怀孕的风险。

近日，妇产科领域权威杂志《obstetrics and gynecology》发表了研究文章，旨在探讨醋酸甲羟孕酮注射时间对药物流产结局以及随后的6个月内再次妊娠风险的影响。

在一个跨国的随机对照试验中，研究者指定研究对象为醋酸甲羟孕酮进行药物流产的女性，一部分人同时运用米非司酮（米非司酮组），另一部分在自然流产后运用醋酸甲羟孕酮（自然流产组），研究者收集了女性流产的结局、怀孕和超过7个月的避孕情况。从2013年8月至2015年3月，研究者共招收了461名参与者，妊娠期为75天或小于75天的孕妇。


研究者发现在米非司酮组有14/220（6.4%）例患者，而在自然流产组有12/226（5.3%）例患者需要进行手术来完成流产；对于这种差异90%置信区间的上限为4.9%。相比于自然流产组（2/226[0.9%]），流产治疗初期继续妊娠在米非司酮组更为常见（8/220[3.6%]）；差异为2.7%（90%可信区间为0.4–5.6%）。6个月后，在米非司酮组和自然流产组分别有5/213（2.3%）和7/217（3.2%）例女性怀孕（精确对数秩检验，P=0.64）。在随后31天内，使用高度有效的避孕药在米非司酮组更为常见（P<0.001），但在6个月无明显差别。

由此可见，醋酸甲羟孕酮同时给予米非司酮药物流产后没有增加明显的手术风险，但也没有增加继续妊娠的风险。它提高了病人的满意度，但没有任何证据表明这样能够降低6个月内再次怀孕的风险。

原始出处：

Raymond, Elizabeth G, et al. Effects of Depot Medroxyprogesterone Acetate
Injection Timing on Medical Abortion Efficacy and Repeat Pregnancy: A
Randomized Controlled Trial. obstetrics and gynecology.2016. 

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    2017-06-12 yhy100200

    #TET#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2011258, encodeId=1323201125894, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Mon Jun 12 03:42:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043922, encodeId=384d204392233, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Nov 13 16:42:00 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471031, encodeId=542014e103197, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Tue Oct 04 05:42:00 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139561, encodeId=ea0b139561ae, content=这个确实的注意！, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:16:27 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139560, encodeId=bf3d13956025, content=学习了，分享一下！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:15:59 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139255, encodeId=241a139255f0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:26 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139254, encodeId=16d9139254b1, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:18 CST 2016, time=2016-10-02, status=1, ipAttribution=)]
    2016-11-13 1249842em09(暂无昵称)

    #NEC#

    0

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    2016-10-04 周虎

    #孕酮#

    0

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    2016-10-03 1e0d99ddm02(暂无匿称)

    这个确实的注意！

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2011258, encodeId=1323201125894, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Mon Jun 12 03:42:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043922, encodeId=384d204392233, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Nov 13 16:42:00 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471031, encodeId=542014e103197, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Tue Oct 04 05:42:00 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139561, encodeId=ea0b139561ae, content=这个确实的注意！, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:16:27 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139560, encodeId=bf3d13956025, content=学习了，分享一下！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:15:59 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139255, encodeId=241a139255f0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:26 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139254, encodeId=16d9139254b1, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:18 CST 2016, time=2016-10-02, status=1, ipAttribution=)]
    2016-10-03 1e0d99ddm02(暂无匿称)

    学习了，分享一下！

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2011258, encodeId=1323201125894, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Mon Jun 12 03:42:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043922, encodeId=384d204392233, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Nov 13 16:42:00 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471031, encodeId=542014e103197, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Tue Oct 04 05:42:00 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139561, encodeId=ea0b139561ae, content=这个确实的注意！, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:16:27 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139560, encodeId=bf3d13956025, content=学习了，分享一下！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:15:59 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139255, encodeId=241a139255f0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:26 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139254, encodeId=16d9139254b1, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:18 CST 2016, time=2016-10-02, status=1, ipAttribution=)]
    2016-10-02 知难而进

    继续关注

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2011258, encodeId=1323201125894, content=<a href='/topic/show?id=840d1e300e5' target=_blank style='color:#2F92EE;'>#TET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17300, encryptionId=840d1e300e5, topicName=TET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cc52251, createdName=yhy100200, createdTime=Mon Jun 12 03:42:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2043922, encodeId=384d204392233, content=<a href='/topic/show?id=8513126129d' target=_blank style='color:#2F92EE;'>#NEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12612, encryptionId=8513126129d, topicName=NEC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Sun Nov 13 16:42:00 CST 2016, time=2016-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471031, encodeId=542014e103197, content=<a href='/topic/show?id=0b1445323b0' target=_blank style='color:#2F92EE;'>#孕酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45323, encryptionId=0b1445323b0, topicName=孕酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fea57099634, createdName=周虎, createdTime=Tue Oct 04 05:42:00 CST 2016, time=2016-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139561, encodeId=ea0b139561ae, content=这个确实的注意！, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:16:27 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139560, encodeId=bf3d13956025, content=学习了，分享一下！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Mon Oct 03 16:15:59 CST 2016, time=2016-10-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139255, encodeId=241a139255f0, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:26 CST 2016, time=2016-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=139254, encodeId=16d9139254b1, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 02 23:55:18 CST 2016, time=2016-10-02, status=1, ipAttribution=)]
    2016-10-02 知难而进

    谢谢分享！

    0