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KMID : 0370220210650030228
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Yakhak Hoeji
2021 Volume.65 No. 3 p.228 ~ p.236
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Comparison of Clinical Outcomes between Medical Abortion and Surgical Abortion: Systematic Review and Meta-analysis
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Kim Hyun-Jin
Park Su-Lyn
Sohn Hyun-Soon
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Abstract
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According to the recent legal changes concerning abortion in Korea, clinical pharmacists are required toimprove their evidence-based knowledge of medical abortion using mifepristone and misoprostol. This systemic review andmeta-analysis compared clinical outcomes between medical and surgical abortion methods at the first trimester ofpregnancy using acceptability and satisfaction, as well as methods that are currently available worldwide. PubMed,KMbase and KISS databases were utilized for literature searches, and randomized controlled studies reporting completeabortion as a primary endpoint were analyzed. The program Review Manager version 5.4 (Cochrane Collaboration) wasemployed to estimate the pooled risk ratio (RR) with 95% confidence interval (CI); random effect models were appliedfor all analyses. A total of 1,093 studies were identified, nine of which were eligible and selected for a meta-analysis. Thepooled complete abortion rate was higher for surgical abortion than for medical abortion (RR 1.07, 95% CI 1.04-1.09).
As a complication of intervention, bleeding (RR 3.29, 95% CI 2.21-4.91), nausea (RR 2.82, 95% CI 2.26-3.51), vomiting(RR 5.71, 95% CI 3.60-9.06), pain (RR 1.61, 95% CI 1.18-2.20) and fever (RR 2.36, 95% CI 0.97-5.75) all scored higherfor medical abortion than for surgical abortion. However, acceptability (RR 1.25, 95% CI 1.12-1.40) and satisfaction (RR1.60, 95% CI 1.34-1.89) scored higher for medical abortion than for surgical abortion. While medical abortion showedstatistically significant weakness compared with surgical abortion with regard to complete abortion and complications,personal preferences could be better for medical abortion due to surgical intervention related fears. This study couldsignificantly help women who prefer abortion in decision making as well as pharmacists in providing professional servicesregarding miscarriage medicines in clinical settings.
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KEYWORD
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medical abortion, mifepristone, misoprostol, surgical abortion, systemic review, meta analysis
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