Abstract | Godišnje se u svijetu izvede oko 44 milijuna pobačaja. U RH 2015. godine izvedeno je 8 362 pobačaja (prijavljenih), od čega je 1 319 spontanih. Spontani ili habitualni pobačaji mogu nastati zbog raznih uzroka, a najčešće su to anomalije zametka, imunosni poremećaji, endokrinopatije, bolesti majke ili ploda, anomalije maternice te razna okolišna zagađenja. U preko 60 % razlog su kromosomske abnormalnosti. Spontani pobačaj ili rani gubitak trudnoće uvelike mogu utjecati na smanjenje kvalitete života žene i njihove obitelji, a uz emocionalno - psihološki, predstavljaju i veliki socioekonomski problem.
Medikamentozni prekid rane trudnoće izvršava se pomoću dva lijeka, mifepristona, sintetičkog steroida koji se veže za progesteronski receptor puno većim afintiteom od progesterona, te misoprostol koji je jeftin analog prostaglandina E1. U svijetu postoje razni protokoli primjene ovih lijekova, a do sada najuspješnija metoda prekida ranih trudnoća je kombinacija ova dva lijeka. Kao alternativni protokol može se koristiti lijek metotreksat iako on nije preporučen od strane Svjetske zdravstvene organizacije.
Kao neizbježno pitanje, javlja se i pitanje priziva savjesti koji u RH i dalje nije jasno zakonski regulirano.
Medikamentozni prekid trudnoće kao suvremena metoda prekida trudnoće, ima određene prednosti naspram kirurških metoda, a kao najbitnije se navode sigurnost i prirodniji način postupka. |
Abstract (english) | Approximately, 44 million abortions worldwide are carried out annually. In the Republic of Croatia 2015, 8 362 abortions (reported) were performed, out of 1 319 were spontaneous. Spontaneous or abdominal abortions can be caused by various causes, and most commonly they include abnormal embryos, immune disorders, endocrinopathy, mother or child disease, uterine abnormalities, and various environmental pollutants. In over of 60% of cases chromosomal abnormalities are present. Spontaneous abortion or early pregnancy loss can greatly affect the reduction of the quality of life of a woman and their family, and besides of emotional and psychological aspects, it represents a major socioeconomic problem.
A medically terminated early pregnancy is performed using two drugs, mifepristone, a synthetic steroid that binds to the progesterone receptor with much higher progestogen affinity, and misoprostol that is a cheap analogue of prostaglandin E1. In the world, there are various protocols for the use of these drugs, and the most successful method of early pregnancy interruptions is the combination of these two drugs. As an alternative protocol, methotrexate can be used although it is not recommended by the World Health Organization.
As an inescapable question, there is also the question of an invocation of conscientious objection not clearly regulated in Republic of Croatia.
The medically terminated pregnancy as a modern method of interrupting pregnancy has certain advantages over surgical methods, and most importantly, the safety and the more natural method of treatment are mentioned. |