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[Conflicting recommendations between the French national authority for health (HAS) and clinical practice guidelines (CNGOF); focus on 200 late medical abortions, conducted outside marketing authorizations].

Authors
  • Bréard, H1
  • Pressat Laffouilhere, T2
  • Braund, S3
  • Duhamel, O3
  • Réal-Lhommet, A3
  • Machevin, E4
  • 1 Service de gynécologie obstétrique, CHU de Rouen-Normandie, 37, boulevard Gambetta, 76000 Rouen, France. Electronic address: [email protected] , (France)
  • 2 Service de santé publique, CHU de Rouen-Normandie, 37, boulevard Gambetta, 76000 Rouen, France. , (France)
  • 3 Service de gynécologie obstétrique, CHU de Rouen-Normandie, 37, boulevard Gambetta, 76000 Rouen, France. , (France)
  • 4 Service de gynécologie obstétrique, hôpital d'Evreux, centre hospitalier Eure-Seine, rue Léon Schwartzenberg, 27015 Évreux, France. , (France)
Type
Published Article
Journal
Gynecologie, obstetrique, fertilite & senologie
Publication Date
Dec 01, 2019
Volume
47
Issue
12
Pages
854–859
Identifiers
DOI: 10.1016/j.gofs.2019.10.005
PMID: 31626980
Source
Medline
Keywords
Language
French
License
Unknown

Abstract

There are conflicting recommandations about late medical abortion: the French National College of Gynaecologists and Obstetricians (CNGOF) and the French Superior Health Authority are opposed. The aim was to assess misoprostol's efficiency in medical abortions at 9 to 14 weeks gestational age (GA) METHODS: This is an epidemiologic retrospective study led from March 2017 till January 2019, in Evreux's hospital, France, including all patients undergoing a medical abortion from 9 to 14 weeks GA. We followed the CNGOF's recommandations published in 2016. The main efficacy parameter was the failure rate of medical abortion at 9 to 14 weeks GA. The secondary efficacy parameters were the number of patients absent at the post-medical abortion examination, the consumption of misoprostol, the consumption of symptomatic treatment, the type of complication and the length of hospital stay. 200 patients were included: 19 patients had vacuum aspiration, so we report a 10.2 % failure rate (95% CI: 6.4%; 15.7%). 7 (3.5%) had vacuum aspiration for haemorrhage (2 (1%) receveived a blood transfusion) 9 (4.5%) had a vacuum aspiration for failure and 3 (1.5%) for retention. 71 (35.5%) patients were absent at the post-medical abortion examination. The mean consumption of misoprostol was 1234μg (441). The mean length of hospital stay was 12.2hours (8.28). The abortion failure rate is 10.2%. Our study didn't report any elements of bad tolerance of misoprostol in this indication. Copyright © 2019 Elsevier Masson SAS. All rights reserved.

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