RESUMO
There are two methods of abortion : the medical and the surgical methods, each with its own specific benefits. Theoretically, the limit of medical abortion gestational age is 7 weeks of amenorrhea. However, since 2011, our university department provides the opportunity of a drug regimen until 9 weeks of amenorrhea. This paper describes the results of a retrospective study which covers 804 patients who were submitted to a medical abortion with gestational ages of 6 to 9 weeks. The purpose is to investigate the efficiency of the medical approach up to 9 weeks and to assess the drug dose required according to the term of pregnancy. Our work shows an efficiency of 95 % of medical abortion up to 9 weeks gestation, with no significant variation with the gestational age. However, maintaining this level of efficiency during the progress of pregnancy requires an increase of the administered doses of misoprostol. In addition, there is a significant increase in the use of analgesics. The medical abortion procedure remains effective until 9 weeks of gestation. This pharmacological approach reduces the risks induced, in the short and long term by the surgical procedure.
Il existe deux méthodes d'interruption de grossesse : la méthode médicamenteuse et la méthode chirurgicale, présentant chacune leurs avantages et leurs inconvénients. Théoriquement, la limite d'âge gestationnel pour l'IVG médicamenteuse est de 7 semaines d'aménorrhée. Cependant, depuis 2011, notre service universitaire a évalué la possibilité d'étendre l'indication à 9 semaines d'aménorrhée (SA).Cet article décrit les résultats d'une étude rétrospective qui porte sur 804 patientes ayant subi une IVG médicamenteuse avec un âge gestationnel allant de 6 SA à 9 SA. Le but de cette étude est de démontrer l'efficacité de la méthode médicamenteuse d'IVG jusqu'à 9 SA et d'évaluer les dosages médicamenteux nécessaires en fonction du terme de la grossesse. L'efficacité de l'IVG médicamenteuse est de l'ordre de 95 % jusqu'à 9 SA sans variation significative en fonction de l'âge gestationnel. Toutefois, le maintien de ce taux d'efficacité, lors de l'avancement de la grossesse, requiert une augmentation des doses de misoprostol administrées. De plus, on note une majoration significative du recours aux antalgiques. La procédure médicamenteuse d'IVG demeure efficace jusqu'à 9 SA. Cette approche réduit les risques induits par la procédure chirurgicale à court mais aussi à long terme.
Assuntos
Abortivos não Esteroides/uso terapêutico , Aborto Induzido , Misoprostol/uso terapêutico , Primeiro Trimestre da Gravidez , Feminino , Idade Gestacional , Humanos , Histeroscopia , Gravidez , Estudos Retrospectivos , Útero/diagnóstico por imagemRESUMO
Uterine fibromatosis is a frequent benign gynaecological disease causing heavy menstrual bleeding and in some cases anaemia. Until now, medical treatment aimed to obtain amenorrhea by administration of progestins or Gn-RH agonists. By inducing hypo-oestrogenism, a reduction of myoma size is observed with Gn-RH agonists but after cessation of the treatment, initial myoma size is noted. The impact of progesterone in myoma growth is nowadays demonstrated and use of selective modulators of progesterone receptors represents a new medical approach of this disease.
Assuntos
Leiomioma/tratamento farmacológico , Norpregnadienos/uso terapêutico , Neoplasias Uterinas/tratamento farmacológico , Feminino , Humanos , Leiomioma/patologia , Norpregnadienos/farmacologia , Progesterona/metabolismo , Receptores de Progesterona/efeitos dos fármacos , Receptores de Progesterona/metabolismo , Neoplasias Uterinas/patologiaRESUMO
Under the presidency of prof. H. Depypere (UZ Ghent) and Prof. P. Simon (ULB Erasme) a Belgian panel of thirteen experts (gynecologists, representatives of universities and scientific associations for gynecology-obstetrics) reached a consensus on the use of intrauterine systems, both copper IUDs as hormone IUDs, in nultiparous women.
