Medikamentozni prekid neželjene trudnoće

Natalija Vuletić, Jelena Ivandić, Nataša Smajla, Marko Klarić, Herman Haller

Medicinski pobačaj se definira kao prekid trudnoće pomoću lijekova. Mifepriston u kombinaciji s mizopro-stolom najčešći je oblik medikamentoznog prekida trudnoće. Cilj je ovoga rada predstaviti primjenjivost i učinkovitost medikamentoznog prekida neželjene trudnoće u Kliničkom bolničkom centru Rijeka gdje se primjenjuje od sredine 2015. godine. Medicinski pobačaj u KBC Rijeka vrši se prema protokolu Svjetske zdravstvene organizacije za medikamentozni prekid trudnoće od 9. do 12. tjedna trudnoće, a sastoji se od jednokratne peroralne primjene mifepristona u dozi od 200 mg i nakon 36–48 sati vaginalne ili bukalne primjene mizoprostola u dozi od 800 mcg. Nakon 6 sati od primjene prve doze mizoprostola učini se proc-jena stanja ginekološkim i ultrazvučnim pregledom te u slučajevima nedovršenog pobačaja nastavlja se svaka 3 sata s primjenom mizoprostola bukalnim putem u dozi od 400 mcg do najviše 4 dodatne primjene (2400 mcg kumulativne doze mizoprostola). Kombinacijom navedenih lijekova u 860 slučajeva postignuta je uspješnost od 99% (N=851) prekida trudnoće, a u 9 (1,0%) neuspjelih slučajeva prekid trudnoće dovršen je sljedećeg dana kirurškim putem. Ukupna stopa ostatnog tkiva trofoblasta (tzv. rezidua) u navedenoj studiji iznosila je 1,9%. Medikamentozni pobačaj predstavlja sigurnu i učinkovitu metodu prekida neželje-nih trudnoća.

Medical termination is defined as a termination of pregnancy by medications. Mifepristone in combination with misoprostol is the most common protocol of use for medical termination of pregnancy. The aim of this paper is to present the applicability and efficiency of medical termination of unplanned pregnancies at Clinical Hospital Center (CHC) Rijeka, where it has been practiced since the mid-2015. In CHC Rijeka we follow the protocol of the World Health Organization for medical termination of pregnancy from nine up to 12 weeks of gestation. It consists of a single dose of mifepristone 200 mg administered orally, followed by vaginal or buccal administration of misoprostol 800 mcg after 36–48 hours. After six hours of the first dose of misoprostol, gynecological and ultrasound examination determines whether the termination has occurred. In cases of uncompleted termination, the treatment is continued every three hours with the use of buccal misoprostol in a dose of 400 mcg to a maximum of four additional doses (2400 mcg of cumulative dose of misoprostol). Following the above procedure in 860 cases a success rate of 99% was achieved in the termination of pregnancies. Unresolved nine (0.1%) women underwent surgical removal of pregnancy. Total rate of residual tissue of the trophoblast (so-called residua) in this study was 1.9%. Medical termination of unwanted pregnancy represents a safe and effective method of abortion.