Raseduse katkestamise juhend
  • Juhendi üldine teave
  • 1. Lühendid
  • 2. Tõenduspõhisuse määratlus
  • 3. Epidemioloogia
    • 3.1.Eesti Abordiregister
    • 3.2.Eesti Abordistatistika
  • 4. Raseduse katkestamise meditsiinilised, legaalsed ja eetilised aspektid
  • 5.Abordieelne periood
    • 5.1. Raseduse tuvastamine
    • 5.2. Patsiendi nõustamine abordiga kaasnevate sümptomite, tüsistuste ja tagajärgede kohta >
      • 5.2.1. Abordiga kaasnevad sümptomid
      • 5.2.2.Võimalikud tüsistused
      • 5.2.3.Võimalikud tagajärjed
    • 5.3. Abordi meetodi valik
    • 5.4. Uuringud ja kliinilised aspektid
    • 5.5. Kontratseptsiooninõustamine
  • 6. Abordi protseduur
    • 6.1. Kirurgiline abort >
      • 6.1.1. Emakakaela ettevalmistus
      • 6.1.2. Raseduse kestus kuni 12 nädalat
      • 6.1.3. Verejooksu kontroll
      • 6.1.4. Valu kontroll
      • 6.1.5. Varased tüsistused ja käitumistaktika
    • 6.2. Medikamentoosne abort >
      • 6.2.1. Ravimite toimemehhanism, efektiivsus ja ohutus
      • 6.2.2. Vastunäidustused medikamentoosseks abordiks
      • 6.2.3. Ravimite manustamisviisid
      • 6.2.4. Ravimite manustamise skeemid vastavalt gestatsiooniajale >
        • a. Raseduse kestus kuni 9 nädalat
        • b. Raseduse kestus 9–12 nädalat
      • 6.2.5. Valu kontroll
      • 6.2.6. Kõrvaltoimed ja nende ravi
  • 7. Abordijärgne periood
    • 7.1. Anti-reesus profülaktika
    • 7.2. Nõustamine vahetult pärast aborti
    • 7.3. Abordijärgne visiit >
      • 7.3.1. Abordijärgse visiidi eesmärk ja näidustused
      • 7.3.2. Abordi toimumise hindamine
    • 7.4. Tüsistuste käsitlus >
      • 7.4.1. Raseduse jätkumine
      • 7.4.2. Mittetäielik abort
      • 7.4.3. Vaginaalne vereeritus
      • 7.4.4. Palavik/ valu
    • 7.5. Kontratseptsioon
  • Allikaloend
  • Lisad
    • Lisa 1. Kirurgilise abordi nõustamisakt
    • Lisa 2. Med.abordi nõustamisakt
  • Juhend pdfs

Allikaloend
​

​1 World Health Organization. Safe abortion: technical and policy guidance for health systems. Geneva:WHO,2012.
2 Royal College of Obstetricians and Gynaecologists. The Care of Women Requesting Induced Abortion. Evidence-based Guideline Number 7. London: RCOG; 2011. 
3 Raskaudenkeskeytys. Käypä hoito, Suomalainen Lääkäriseura Duodecim 2013. 
4 Tervise Arengu Instituut. Eesti Meditsiiniline Sünni- ja Abordiregister.
5 Gissler M, Fronteira I, Jahn A, Karro H, Moreau C, da Silva MO et al. Terminations of pregnancy in the European Union. Br J Obstet Gynaecol 2012;119:324–32.

6 Laanpere M, Ringmets I, Part K, et al. Induced abortion trends from 1996 to 2011 in Estonia: special emphasis on repeat abortion. BMC Womens Health 2014;14:81.
​
7 Haldre K, Part K, Ketting E. Youth sexual health improvement in Estonia, 1990–2009: The role of sexuality education and youth-friendly services. Eur J Contracep Repr 2012; 7:351–6.
8 Raseduse katkestamise ja steriliseerimise seadus. 
9 European Board and College of Obstetrics and Gynaecology Standards of Care for Women. Standards of Care for Women’s Health in Europe, 2014. 
10 World Health Organization. Clinical Practice Handbook for Safe Abortion. Geneva: WHO, 2014. 
11 Ethical issues in Obstetrics and Gynecology by the FIGO Committee for the Study of Ethical Aspects of Human Reproduction and Women’s Health. London: FIGO, 2012.
12 Royal College of Obstetricians and Gynaecologists. Best practice in comprehensive abortion care. Best Practice Paper No. 2. London: RCOG, 2015. 
13 Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol 2012;119:215-9.
14 Say L, Brahmi D, Kulier R, Campana A, Gülmezoglu AM. Medical versus surgical methods for first trimester termination of pregnancy. Cochrane Database Syst Rev 2005;(1):CD003037.
15 Niinimäki M, Pouta A, Bloigu A, Gissler M, Hemminki E, Suhonen S, et al. Immediate complications after medical compared with surgical termination of pregnancy. Obstet Gynecol 2009;114:795–804.
16 Kaunitz AM, Rovira EZ, Grimes DA, Schulz KF. Abortions that fail. Obstet Gynecol 1985;66:533–7.
17 Bygdeman M, Danielsson KG. Options for early therapeutic abortion. A comparative review. Hum Reprod Update 2007;13:37–52.
18 Department of Health. Abortion Statistics, England and Wales: 2009. Statistical Bulletin 2010/1.London: DH; 2010. 
19 Heisterberg L, Hebjorn S, Andersen LF, Petersen H. Sequelae of induced first-trimester abortion. A prospective study assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics. Am J Obstet Gynecol 1986;155:76-80.
20 National Collaborating Centre for Mental Health. Induced abortion and mental health. A
systematic review of the mental health outcomes of induced abortion, including their
prevalence and associated factors. Academy of Medical Royal Colleges, 2011. 
21 Klemetti R, Gissler M, Niinimaki M, Hemminki E. Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Human Reproduction 2012;27:3315–20.
​22 International Federation of Planned Parenthood. First trimester abortion guidelines and protocols Surgical and medical procedures, London: IPPF, 2008. 
23 ​Lohr PA, Fjerstad M, DeSilva U, Lyus R. Abortion – clinical review. BMJ 2014;348:f7553.
24 Low N, Mueller M, Van Vliet HAAM, Kapp N. Antibiotic prophylaxis for medical and surgical first-trimester induced abortion. Review by the Cochrane Collaboration.The Cochrane Library 2012, Issue 3.
25 Achilles SL, Reeves MF; Society of Family Planning. Prevention of infection after induced abortion: release date October 2010: SFP Guideline 20102. Contraception 2011;83:295–309.
26 World Health Organization. Medical eligibility criteria for contraceptive use. Geneva: WHO, 2015.
27 Kapp N, Lohr PA, Ngo TD, Hayes JL. Cervical preparation for first trimester surgical
abortion. Cochrane Database Syst Rev 2010;2:CD007207.

28 American College of Obstetricians and Gynaecologists. Medical Management of First-Trimester Abortion. AGOG, 2014. 
29 ​Bartley J, Tong S, Everington D ym. Parity is a major determinant of success rate in medical abortion: a retrospective analysis of 3161 consecutive cases of early medical abortion treated with reduced doses of mifepristone and vaginal gemeprost. Contraception 2000;62:297-303.
30 Ashok PW, Templeton A, Wagaarachchi PT ym. Factors affecting the outcome of early medical abortion: a review of 4132 consecutive cases. BJOG 2002;109:1281‒9.
31 von Hertzen H, Honkanen H, PiaggioG, Bartfai G, Erdenetungalag R, Gemzell-Danielsson  et al. WHO multinational study of three misoprostol regimens after mifepristone for early medical abortion. I: Efficacy. BJOG 2003; 110: 808‒18.
32 Fonseca W, Alencar AJ, Mota FS, Coelho HL. Misoprostol and congenital malformations. Lancet 1991;338:56.
33 World Health Organization. Frequently asked clinical questions about medical abortion. Geneva: WHO, 2006. 
34 Ngo TD, Park MH, Shakur H, Free C. Comparative effectiveness, safety and acceptability
of medical abortion at home and in a clinic: a systematic review. Bull World Health Organ
2011;89:360-70.

35 Fiala C, Fux M, Gemzell DK. Rh-prophylaxis in early abortion. AOGS 2003;82:892–903.
36 Fiala C, Gemzell-Danielsson K. Review of medical abortion using mifepristone in combination with a prostaglandin analogue. Contraception 2006;74:66–8.
37 Wolman I, Altman E, Faith G, Har-Toov J, Amster R, Gull I, Jaffa AJ. Combined clinical and ultrasonographic work-up for the diagnosis of retained products of conception. Fertil Steril 2009;92:1162–4.
38 Oppegaard K, Qvigstad E, Sunde K, Fiala C, Heikinheimo O, Benson L, Gemzell-Danielsson K. Clinical follow-up compared with self-assessment of outcome after medical abortion: a multicentre, non-inferiority, randomised, controlled trial. Lancet Glob Health 2015;3:e537‒45.
39 Cameron ST, Glasier A, Dewart H, Johnstone A, Burnside A. Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: a service evaluation. Contraception 2012;86:67–73.
40 Michie L, Cameron ST. Simplified follow-up after early medical abortion: 12-month experience of a telephone call and self-perfomed low-sensitivity urine pregnancy test. Contraception 2014;89:440–45.
41 Reeves MF, Kudva A, Creinin MD. Medical abortion outcomes after a second dose of
misoprostol for persistent gestational sac. Contraception 2008;78:332-5.

42 Cameron IT, Baird DT. The return to ovulation following early abortion: a comparison between vacuum aspiration and prostaglandin. Acta Endocrinol 1988;118:161–7.
43 Royal College of Obstetricians and Gynaecologists. Faculty of Sexual and Reproductive Healthcare Clinical Guidance Quick Starting Contraception Clinical Effectiveness Unit. RCOG; London, 2010.
44 Gaffield ME, Kapp N, Ravi A. Use of combined oral contraceptives post abortion. Contraception 2009;80:355–62.
Ülesse

Eelmine                                                                                                                                               Järgmine

Powered by Create your own unique website with customizable templates.