tailieunhanh - Induced Abortion Guidelines

 Objective: To provide an updated guideline for the surgical and medical termination of pregnancy. This guideline discusses and compares the safety and effectiveness of currently available pregnancy termination procedures. | SOGC CLINICAL PRACTICE GUIDELINES No 184 November 2006 Induced Abortion Guidelines These guidelines were reviewed by the Clinical Practice-Gynaecology Committee and the Social and Sexual Issues Committee and approved by the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada. PRINCIPAL AUTHOR Victoria Jane Davis MD Abstract Objective To provide an updated guideline for the surgical and medical termination of pregnancy. Options This guideline discusses and compares the safety and effectiveness of currently available pregnancy termination procedures. Outcomes To provide safe and effective methods for the termination of pregnancy. Evidence The Medline EMBASE and Cochrane databases were searched for relevant articles published between January 1999 and July 2005 related to medical or surgical termination of pregnancy. In addition specialist gynaecologists and physicians providing termination services were surveyed to determine current practices and opinions. Values The results of the survey and evidence collected from the literature search were reviewed by members of the Clinical Practice-Gynaecology Committee and the Social and Sexual Issues Committee. Recommendations were quantified using the Evaluation of Evidence criteria developed by the Canadian Task Force on the Periodic Health Examination Table .86 Summary Statements 1. Women choosing pregnancy termination are entitled to quality care by trained practitioners. III 2. Preoperative treatment with metronidazole decreases the risk of postoperative pelvic inflammatory disease in patients with bacterial vaginosis. I 3. Medical abortion and suction curettage are safe and effective alternatives up to 56 days gestation. However medical abortion is associated with a higher rate of persistent viable gestation. II-1 4. Preprocedural cervical dilatation facilitates vacuum aspiration and decreases the incidence of cervical laceration and uterine perforation. II-2 5. Prophylactic antibiotics .