Pain during medical abortion in early pregnancy in teenage and adult women
| Autor: | V.J. Palkama, Venla Kemppainen, Maarit Mentula, Oskari Heikinheimo |
|---|---|
| Přispěvatelé: | HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital Area, Clinicum, Department of Diagnostics and Therapeutics, HUS Perioperative, Intensive Care and Pain Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_treatment
induced abortion Abortion DOUBLE-BLIND 0302 clinical medicine Drug Utilization Review Pregnancy MISOPROSTOL 3123 Gynaecology and paediatrics TERMINATION Medicine pain 030212 general & internal medicine PREDICTORS Misoprostol Tramadol Pain Measurement Analgesics 030219 obstetrics & reproductive medicine Obstetrics Obstetrics and Gynecology General Medicine 16. Peace & justice Medical abortion 3. Good health first-trimester abortion Drug Therapy Combination Female Oxycodone medicine.drug Adult medicine.medical_specialty Adolescent Narcotic Visual analogue scale Analgesic Risk Assessment 03 medical and health sciences teenager IBUPROFEN Humans Pain Management ANALGESIA USE Acetaminophen Abortifacient Agents Nonsteroidal business.industry MIFEPRISTONE Abortion Induced 3126 Surgery anesthesiology intensive care radiology RELIEF medical abortion business |
| Popis: | INTRODUCTION Women experience pain during medical abortion, yet optimal pain management remains unclear. We studied the pain experience and need of analgesics during early medical abortion (≤63 days of gestation) among teenage and adult women. We also assessed predictive factors of severe pain. MATERIAL AND METHODS We recruited 140 primigravid women: 60 teenagers and 80 adult women aged between 25 and 35 years old. The group of teenagers included 19 women under the age of 18 years old (minors). The abortion was performed with mifepristone (200 mg) followed by vaginal misoprostol (800 μg), mainly self-administered at home for adults. Minors were hospitalized during misoprostol administration. Pain medication consisted of ibuprofen 600 mg and paracetamol 1000 mg, first doses taken simultaneously with misoprostol and repeated, if needed, up to three times daily. Additional opiates (mainly tramadol or oxycodone) were administered at hospital if needed. Pain was measured using the visual analogue scale (VAS, 0-100 mm). RESULTS The maximal pain VAS (median, interquartile range) was 75 (54-91). Of all the women, 57.7% experienced severe pain (VAS ≥70) during abortion care and 93.5% of women needed additional analgesics in addition to prophylactic pain medication. Teenagers needed additional analgesics more often than adults (5 [3-8] vs 3 [2-6] times, P = .021); 38.0% of all teenagers (64.7% of the minors) received additional opiates compared with 7.9% in adult women. Severe pain (VAS ≥70) was associated with history of dysmenorrhea (adjusted odds ratio [OR] 2.60 [95% confidence interval [CI] 1.21-5.59, P = .014]), anxiety at baseline (2.64 [1.03-6.77], P = .044) and emesis during abortion (5.24 [2.38-11.57], P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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