最初の3ヶ月間の妊娠中絶の管理:遡及的監査
Rami Musallam1, Nabeel Salem1, Ramez Al Halol1
1Ministry of Health, Gaza City, Gaza Strip, occupied Palestinian territory.
Lancet (London, England)
|March 20, 2018
まとめ
この研究では 妊娠の最初の3ヶ月間での 妊娠中絶の治療は しばしば失敗し ほとんどの場合 手術が必要であることが 分かりました 手術後の抗生物質予防のガイドラインも順守されず,患者のケアに影響を及ぼしました.
科学分野:
- 産婦人科
- 生殖 健康
- 臨床監査
背景:
- 最初の3ヶ月間の妊娠中絶は,認められた妊娠の10%に影響し,80%は早期に発生します.
- 患者中心のケアには 妊娠中絶の選択肢を提供する必要があります
- この研究は,ガザ地区のラファにあるエミレーツ病院での妊娠中出の管理を評価したものです.
研究 の 目的:
- アメリカ産婦人科大学 (ACOG) の妊娠中絶の管理に関するガイドラインの遵守を評価する.
- 医学的および外科的管理プロトコルの改善を図る.
- 治療の選択肢について 患者の選択を評価する.
主な方法:
- 2015年11月から12月までの50件の妊娠中絶の事後調査
- 経営慣行とACOGガイドラインの比較 (No. 150,2015年5月) でした.
- 患者の医療記録から抽出したデータです.
主要な成果:
- ACOGのガイドラインの遵守が低いため,ほとんどのケースで医学的管理は失敗しました (86%は手術が必要でした).
- 抗生物質の予防は 86% の手術で不適切に使用された.
- 患者は急性出血がない限り,医療と外科治療の選択肢を与えられませんでした.
結論:
- ACOGのガイドラインからの有意な偏差は,第1期妊娠中絶の医学的および外科的管理の両方で観察されました.
- 明確な証拠に基づいた現地ガイドラインの制定は,医療管理の成果を改善し,患者の選択を提供するために不可欠です.
- 定期的な監査とフィードバックは,抗生物質予防を含む確立されたプロトコルへの遵守を強化するために推奨されます.
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