The ICMA Information Package on Medical Abortion

Lkfn;ksa ls fo’o esa gj txg efgykvksa us vupkgs ;k vle; xHkksZa ds lekiu ds gd dks eglwl fd;k gS] vkSj ,slk djus ds fy, muds ikl tks Hkh rjhds miyC/k Fks ;k ftudh tkudkjh Fkh] mudk ç;ksx fd;kA vk/kqfud fpfdRlk rduhd ds fodkl us vc efgykvksa ds fy, muds thou vkSj muds LokLF; dks [krjs esa Mkys fcuk] ‘kY;fpfdRlk }kjk xHkZ lekiu dks laHko cuk fn;k gSA

1988 esa igyh ckj Ýkal esa] ‘kY;fpfdRlk }kjk xHkZikr ds fodYi] ;kfu ,d ;k nks nokvksa dk feJ.k tks xHkZikr dks çsfjr djrk gS ¼**xHkZikr xksfy;ka^^½] mUgsa ykblsal fn;k x;k FkkA nks esa ls ,d nok] feQsfçLVksu] dks vc ¼2005½ 35 ns’kksa ,LVksfuvk] fQuyS.M] Ýkal] tkWftZ;k] teZuh] xzhl] xq,uk] gaxjh] Hkkjr] bTkzjkby] ykrhfo;k] yDlecxZ] ekWynksfo;k] ukosZ] uhnjyS.Ml~] U;wthyS.M] :lh x.kjkT;] nf{k.k vÝhdk] LiSu] LohMu] fLoV~tjyS.M] rkbZoku] rquhf’k;k] ;wØsu] ;wukbVsM fdaxMe] ;w-,l-,-] mt+csfxLrku] fo;ruke ¼jsQjsal Gynuity website½ ykblsal çnku fd;k x;kA] esa ykblsal çkIr gSA phu esa 2 djksM+ 20 yk[k ¼22 fefy;u½ vkSj ‘ks”k fo’o dh 40 yk[k ¼4 fefy;u½ ls vf/kd efgykvksa us xHkZ lekiu ds fy, bl fof/k dk ç;ksx fd;k gS] vkSj bls lqjf{kr ,oa çHkko’kkyh ik;k gS [1]A

nwljh nok] felksçksLVy] 80 ls Hkh vf/kd ns’kksa esa] ukWu&LVhjk;My ,aVh&bu¶ysesVjh ¼non-steroidal anti-inflammatory½ nokvksa ds ç;ksx }kjk gksus okys xSfLVªd vYljksa dh jksdFkke ds fy, iathÑr gS [2]A bl çdkj] ftu ns’kksa esa feQsfçLVksu vHkh rd iathÑr ugha gqbZ gS] ogk¡ felksçksLVy miyC/k gSA

cgqr ls ns’kksa esa] blesa oks ns’k Hkh ‘kkfey gSa tgk¡ xHkZikr ij dkuwuh çfrca/k gSa ;k igq¡p lhfer gS] ogk¡ buesa ls ,d ;k ;s nksuksa nok,a QkesZlh ds dkamVj ij miyC/k gSaaA gky ds v/;;uksa ls Kkr gqvk gS fd cgqr lh efgykvksa dks xHkZikr xksfy;ksa ds ckjs esa vkSj vf/kd tkudkjh dh vko’;drk gS] fo’ks”kdj mu ns’kksa esa tgk¡ xHkZikr lsok,a lhfer gSaA ç’u& ds :i esa çLrqr QSDV ‘khV mUgsa **xHkZikr xksfy;ka^^ ds ckjs esa efgykvksa }kjk iwNs tkus okys vke ç’uksa dk ljy rjhds ls mŸkj çnku djrh gSA bldk mn~ns’; efgykvksa dks] ,d lqjf{kr vkSj çHkko’kkyh xHkZikr ds fy, ç;ksx dh tkus okyh nokvksa ds ckjs esa tkudkjh çnku djuk gS] rkfd os xHkZ lekiu ds ckjs esa lwfpr fu.kZ; ysus esa l{ke cu ldsaaA mu ns’kksa esa tgk¡ xHkZ lekiu dkuwuh :i ls miyC/k gS] ;fn laHko gks] efgyk,a ;fn bu nokvksa dks LokLF; çnkrk dh ns[kjs[k esa ç;ksx djsa] rks ;g muds fy, lcls vf/kd lqjf{kr gksxkA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr og fof/k gS ftlesa xHkZ lekiu ,d ;k nks nokvksa ds feJ.k ds ek/;e ls fd;k tkrk gSA

Top of the page

Mail to a friend

Print Version

vkikrdkyhu xHkZfujks/k ¼bZ-lh-½ ds fy, ç;ksx dh tkus okyh xksfy;ka] **eksfuZax&vkQVj^^ xksyh ds uke ls Hkh tkuh tkrh gSaA budk ç;ksx v.MksRlxZ dks çHkkfor dj xHkkZ/kku jksdus ds fy, fd;k tkrk gS] ysfdu ;s igys ls Bgjs gq, xHkZ esa dksbZ n[ky ugha nsrhA nwljh vksj] vkS”k/kh; xHkZikr] igys ls xHkZorh efgykvksa esa xHkZikr dks çsfjr djrh gSaA

bZ-lh- xksfy;ka] [kkus okyh xHkZfujks/kd xksfy;ksa ds eqdkcys çkstsLVsjksu&tSls gkWjeksu dh dgha vf/kd [kqjkd ls curh gSA bUgsa fuEufyf[kr ifjfLFkfr;ksa esa efgyk }kjk ç;ksx fd;k tkrk gS] ;fn%

• lcls gky ds laHkksx ds nkSjku] efgyk vkSj mlds lkFkh nksuksa esa ls fdlh us Hkh xHkZfujks/kd ç;ksx u fd;k gks ;k
• mUgsa Mj gks fd xHkZfujks/kd foQy jgk gS ¼vFkkZr dkWuM~e QV x;k ;k ;ksfu ds vanj pyk x;k gks½
• ;kSfud laHkksx fiNys 120 ?kaVksa ds vanj gqvk gksA

vlqjf{kr laHkksx ds ckn ftruh tYnh laHko gks mruh tYnh bZ-lh- xksyh ys ysuh pkfg,A xksfy;ka ftruh tYnh yh tk,axh] mruh gh vf/kd çHkko’kkyh gksaxhA ;fn xksfy;ka vlqjf{kr laHkksx ds 120 ?kaVksa ds vanj ugha yh xbZ] rks bZ-lh- ‘kk;n xHkkZ/kku dks jksdus easa lQy ugha gksaxhA bZ-lh- xksfy;ka xHkkZ/kku jksdus esa de çHkko’kkyh gSa vkSj buds nq”çHkko vf/kdrj fu;fer xHkZfujks/kd mik;ksaa ls vf/kd gSaA bLrseky djus ds ckn bZ-lh- xksfy;ka vkxs vlqjf{kr laHkksx dh fØ;kvksa ls lqj{kk çnku ugha djrhA blfy, bUgsa fu;fer ç;ksx ds fy, mfpr ugha le>k tkrkA ¼vkikrdkyhu xHkZfujks/kd ij vkSj vf/kd tkudkjh ds fy,  www.cecinfo.org ns[ksaA½

Top of the page

Mail to a friend

Print Version

feQsfçLVksu vkSj felksçksLVy ¼Mifepristone and Misoprostol½
fuEufyf[kr vkS”k/kh; xHkZikr ds fy, lcls vkerkSj ij ç;ksx dh tkus okyh nokvksa dk feJ.k fuEufyf[kr gS%

1. feQsfçLVksu] ,d çkstsLVkstsu&jks/kh ¼anti-projestogen½] nok tks igys [kkbZ tkrh gS] vkSj
2. felksçksLVy] çksLVkXySfMax ¼prostaglanding½ nok] tks 24&48 ?kaVksa ds ckn yh tkrh gS

feQsfçLVksu xHkkZ’k; dh ijr dks iryk djrh gS rFkk ljfoDl dks uje cukrh gS vkSj felksçksLVy ds lkFk feykus ls xHkkZ’k; esa rst ladqpu iSnk djrh gSA ;s nok,a lkFk feydj xHkZ ds mRiknksa dks fu”dkflr djrh gSaA bldk ifj.kke LokHkkfod :i ls xHkZ fxjus ;k xHkZikr dh rjg gh gksrk gS [3]A
feQsfçLVksu vkerkSj ij **fefQçsDl^^] **feQsthu^^ ;k **feQstsLV^^ ¼Mifiprex, Mifegyne or Mifegest½ ds uke ls miyC/k gksrh gSA Hkkjr vkSj phu esa ;s dbZ vU; czkaMksa ds uke ls csph tkrh gSaA felksçksLVy vkerkSj ij **lkbZVksV^^] **vkWDLkkçksLV^^ ;k **lk,VksçksLV^^ ¼Cytotech, Oxaprost or Cytoprost½ ukeksa ls miyC/k gSA 
dsoy&felksçksLVy
dqN LFkkuksa ij] vkS”k/kh; xHkZ lekiu ds fy, dsoy çksLVkXySfMax ¼prostaglanding½ felksçksLVy dk ç;ksx fd;k tkrk gSA ,slk blfy, gksrk gS D;ksafd ;k rks feQsfçLVksu ogk¡ miyC/k ugha gksrh ;k [kjhnus dh lkeF;Z ds ckgj gksrh gSA tc dsoy felksçksLVy dk ç;ksx fd;k tkrk gS] ;g ladqpu iSnk djrh gS]  ljfoDl dks uje cukrh gS vkSj xHkZ ds mRikn fu”dkflr gks tkrs gSaA ysfdu feQsfçLVksu ds iwoZ&mipkj ds fcuk] felksçksLVy dh vf/kd [kqjkd dh vko’;drk gksrh gSA xHkZikr dh çfØ;k esa vf/kd nq”ifj.k gks ldrs gSa vkSj lkFk gh lg yEch vkSj ihM+knk;d gks ldrh gS ¼3½A feQsfçLVksu ds feJ.k ds lkFk rqyukRed :i ls iw.kZ xHkZikr dh laHkkouk Hkh de gksrh gSA ysfdu felksçksLVy vU; tksf[keiw.kZ vkSj ,sls xHkZikr mik;ksa ls vf/kd lqjf{kr fodYi gS ftuessa foLr`r ‘kkjhfjd tk¡p dh vko’;drk gksrh gS] ftudk ç;ksx efgyk,a lqjf{kr xHkZikr lsokvksa dh vuqifLFkfr esa djrh gSaA[3]A
eSFkksVªsDtsV vkSj felksçksLVy ¼Methotrexate and misoprostol½
ftu ns’kksa esa feQsfçLVksu miyC/k ugha gS] ogk¡ felksçksLVy ds lkFk eSFkksVªsDtsV dk ç;ksx fd;k tkrk gSA gkyk¡fd] xHkZikr çsfjr ¼bu~M;wl½ djus ds fy, fo’o LokLF; laxBu ¼MCY;w-,p-vks-½ }kjk eSFkksVªsDtsV dk lq>ko igys ls Bgjs gq, xHkZ esa Hkzw.k foÑfr dk tksf[ke c<+ tkus ds Mj ds dkj.k ugha fn;k tkrk][4]A blesa xHkZikr dh çfØ;k Hkh dkQh vf/kd yEch gksrh gSA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr dks fcYdqy ‘kq#vkr ls ysdj vafre ekgokjh ¼,y-,e-ih-½ ds igys fnu ls fxu dj 24 lIrkg rd ç;ksx fd;k tk ldrk gS A gkyk¡fd] ,slh efgyk,a Hkh gksrh gSa ftUgsa xHkZ ds 24 LkIrkg rd xHkZikr dh vko’;drk gks ldrh gS vkSj vkS”k/kh; xHkZikr mik;ksa dk xHkkZoLFkk dh ml voLFkk rd v/;;u fd;k x;k gSA  ] [4]A gkyk¡fd] 9&13 lIrkg ds vkSj 13&24 lIrkg ds xHkZ ds fy,] 9 lIrkg ij [kqjkd vkSj [kqjkd ysus ds rjhds cny tkrs gSa [5]A

Top of the page

Mail to a friend

Print Version

;fn efgyk dks fuEufyf[kr esa ls dksbZ Hkh LokLF; leL;k gks rks mls vkS”k/kh; xHkZikr ds fy, feQsfçLVksu@felksçksLVy rjhds dk ç;ksx u djus dh lykg nh tkrh gS [6]%

• mlds LokLF; çnkrk dks lansg gS ;k mlus fuf’pr rkSj ij crk fn;k gS fd efgyk dks vLFkkuh ¼,sDVkSfid½ xHkZ gS ¼ckWDl 2 ns[ksa½A
• mls feQsfçLVksu ls ,ythZ gS A
• mls felksçksLVy ls ,ythZ gS4A
• mls ,slh chekjh gS ;k ,slh fLFkfr gS tks jDr teus dh {kerk dks çHkkfor djrh gSA
• og jDr dks iryk djus ds fy, nok ys jgh gSA
• og dqN fo’ks”k nok,a ys jgh gSA ;fn og yEcs le; ls xfB;k] vLFkek vkSj vU; ,ythZ okyh fLFkfr;ksa ds fy, xksfy;ka ;k batsD’ku ys jgh gS] rks mls ;g tk¡p djuh pkfg, fd nokvksa esa dksjfVdksLVSjkSMl~ ¼Corticosteroids½ rks ugha gSaA ;fn lansg gks rks] mlds LokLF; çnkrk ls laidZ fd;k tk ldrk gSA
• og yEcs le; ls vf/ko`Dd xzafFk;ksa ¼Adrenal glands½ esa [kjkch ls xzLr gksA vf/ko`Dd xzafFk;ka ¼Adrenal glands½ NksVh] frdksuh xzafFk;ka gksrh gSa tks xqnsZ ds Åij fLFkr gksrh gSa vkSj vWMªhuykbu ¼Adrenaline½] tks ‘kjhj }kjk ruko ls fuiVus esa lgk;rk ds fy, vfuok;Z gksrs gSa] lesr fofHké çdkj ds gkWjeksu iSnk djrh gSaA
• mls vuqokaf’kd :i ls ikSjQjhl~ ¼Porphyries½ gksA ;g dqN fo’ks”k ,Ut+kbeksa dh ,d vlkekU; foÑfr gS tks çksVhuksa esa ykSg rRo okys fixesUV cukus ds fy, ftEesnkj gksrh gSA

felksçksLVy ls ,ythZ dks NksM+ dj] Åijfyf[kr dksbZ Hkh fLFkfr dsoy&felksçksLVy ds ç;ksx ds fy, ykxw ugha gksrhA

;fn ,d efgyk ds xHkkZ’k; esa vkbZ-;w-Mh- yxk gqvk gS] rks feQsfçLVksu@felksçksLVy ds feJ.k ;k dsoy&felksçksLVy ds ç;ksx }kjk vkS”k/kh; xHkZikr ls igys mls fudky nsuk pkfg,A

gYds ;k lkekU; vuhfe;k ¼gheWXykscbu~ dk Lrj 9 vkSj 12 gm/dl ds chp½ okyh efgyk,a vkS”k/kh; xHkZikr dk ç;ksx dj ldrh gSaA gkyk¡fd] gYds ;k lkekU; vuhfe;k okyh efgykvksa ds fy, vkS”k/kh; ;k ‘kY;fØ;k ls xHkZikr dk ç;ksx djrs le; ykSg rRo dh xksfy;ka ysuk ykHkdkjh gks ldrk gSA

Top of the page

Mail to a friend

Print Version

vLFkkuh ¼,sDVkSfid½ xHkZ ,d ,slh fLFkfr gS ftlesa fu”ksfpr v.Mk.kq xHkkZ’k; dh Hkhrjh lrg dh ctk; fdlh vU; LFkku ij Bgj tkrk gS vkSj fodflr gksrk gSA vf/kdka’k vLFkkuh ¼,sDVkSfid½ xHkZ fMEcokgh uyh ¼QSyksfivu V~;wc½ ¼95%½ esa gksrs gSa( gkyk¡fd] xHkZ vU; LFkkuksa tSls v.Mk’k;] ljfoDl ;k isV dh [kks[kyh txg esa Hkh Bgj ldrk gS [7]A

vkjafHkd voLFkk esa vLFkkuh ¼,sDVkSfid½ xHkZ ds y{k.k utj ugha vkrsA vLFkkuh ¼,sDVkSfid½ xHkZ ds y{k.k vDlj Hkzfer djus okys gksrs gSa] vkSj buesa ;ksfu ls jDrlzko] isV ;k isV ds fupys fgLls esa nnZ ¼vkerkSj ij ,d rjQ tksj ls½] da/ks esa nnZ] det+ksjh ;k pDdj vkuk ‘kkfey gks ldrk gSA ;s y{k.k vU; fLFkfr;ksa esa Hkh gks ldrs gSa] tSls fd v.Mk’k; Ñfedks”k ¼flLVl~½] LokHkkfod xHkZikr] ;k lkekU; xHkZA

iSfYod tk¡p ds le; dHkh dHkh] MkDVj dks uje xk¡B eglwl gks ldrh gSA ;fn vLFkkuh ¼,sDVkSfid½ xHkZ dk lansg gks] rks funku vkSj iqf”V djus ds fy, chVk ,plhth ¼Beta hCG½ jDr tk¡p] vkSj vYVªklkmaM dh lgk;rk yh tk ldrh gS [7]A 

Top of the page

Mail to a friend

Print Version

bl ckr dk dqN çek.k gS fd feQsfçLVksu dk çHkko ek¡ ds nw/k ij gksrk gS] ysfdu f’k’kq ds vf/ko`Dd dk;Z ¼Adrenal function½ ij blds fdlh çHkko ds ckjs esa cgqr de çek.k gSaA tks çek.k miyC/k gS mlls irk pyrk gS fd feQsfçLVksu dh tks ek=k nw/k }kjk f’k’kq esa tkrh gS mlls dksbZ uqdlku gksus dh laHkkouk  ugha gS [8] A

felksçksLVy ysus ds ckn bldh FkksM+h ek=k ek¡ ds nw/k esa vk tkrh gS] ysfdu ;g irk ugha gS fd bldk f’k’kq ij dksbZ çHkko gksrk gS ;k ughaA pwafd felksçksLVy dk Lrj dkQh rsth ls fxjrk gS] ;g dgk tkrk gS fd felksçksLVy [kkus ds ekeys esa] bls Lruiku djkus ds rqjar ckn [kk;k tkuk pkfg, vkSj vxyk Lruiku pkj ?kaVs ckn djkuk pkfg, vkSj ;fn ;ksfu esa ç;ksx fd;k x;k gks rks ç;ksx djus ds dqN nsj ckn Lruiku djk;k tk ldrk gS [9] A  

gkyk¡fd] ;fn efgyk dks Mj gks fd nok dk çHkko mlds nw/k esa vk tk,xk] rks feQsfçLVksu@felksçksLVy ;k dsoy& felksçksLVy ç;ksx djus ds ckn 24 ?kaVksa rd nw/k dks fudky nsuk pkfg,A

Top of the page

Mail to a friend

Print Version

,slk dksbZ dkj.k ugha gS fd ,p-vkbZ-oh- ikWftfVo efgyk,a vkS”k/kh; xHkZikr dk ç;ksx ugha dj ldrhA  ,p-vkbZ-oh- ikWftfVo efgykvksa dks xHkZ ds cps gq, mRiknksa ls tuukax ekxZ ds laØe.k gksus dk tksf[ke vf/kd gks ldrk gS] ysfdu ,slk fpfdRlh; ;k ‘kY;fØ;k }kjk xHkZikr esa Hkh gks ldrk gSA

fo’ks”kdj ;fn mUgsa eysfj;k gS rks] ;k os dqN fo’ks”k ,aVhjsVªksokbjy ¼,-vkj-oh-½ ys jgh gSa rks mUgsa vuhfe;k dk tksf[ke Hkh gks ldrk gS] vkSj ,sls esa ykSg rRo dh xksfy;kas dk funsZ’k Hkh fn;k tk ldrk gSA efgykvksa dh ,d NksVh la[;k ftuesa vf/kd jDrlzko gksrk gS] muesa xaHkhj ifj.kkeksa lss cpus ds fy, muds ‘kh?kz mipkj dh vko’;drk gksrh gSA

Top of the page

Mail to a friend

Print Version

,slk dksbZ fpfdRlh; dkj.k ugha gS fd vkS”k/kh; xHkZikr fd’kksfj;ksa ds fy, mfpr u gksA dksbZ Hkh efgyk tks igys xHkZorh ugha gqbZ gS mlds fy, vkS”k/kh; xHkZikr vf/kd IkhM+knk;d gksrk gS] vkSj bldk vFkZ gS fd tks ;qok efgyk,a vHkh rd ,d ckj Hkh xHkZorh ugha gqbZ gSa mUgsa tUe ns pqdh efgykvksa dh rqyuk esa nnZ ds fy, vf/kd nok dh vko’;drk gksxhA

cgqr ls ns’kksa esa] vfookfgr fd’kksfj;ka vkSj vU; ;qok efgyk,a] ftUgsa ‘kY;fØ;k }kjk lqjf{kr xHkZikr dh lqfo/kk miyC/k ugha gS] muds fy, vkS”k/kh; xHkZikr dh miyC/krk fo’ks”k:i ls lgk;d gks ldrh gSA

Top of the page

Mail to a friend

Print Version

,d efgyk dks ;g ekywe gks ldrk gS fd mls çtuu ekxZ dk laØe.k ¼vkj-Vh-vkbZ-½ gS D;ksafd og mlds fy, mipkj djk jgh gS ;k mls lQsn ;k ihyk@gjk cncwnkj lzko] tuukaxksa esa [kqtyh ;k ?kko] ;k ckj ckj nnZ ds lkFk is’kkc vkus tSls y{k.k eglwl gksus ls vkj-Vh-vkbZ- gksus dk lansg gks ldrk gSA ,sls esa mipkj esa nsjh ugha djuh pkfg, D;ksafd fcuk bykt ds laØe.k ls] cka>iu lesr vU; xaHkhj LokLF; leL;k,a gks ldrs gSaA

vkS”k/kh; xHkZikr ds fy, tc efgyk LokLF; dsanz esa igyh ckj vkrh gS] ml le; LokLF; çnk;d dks isfYod tk¡p lesr] iwjh ‘kkjhfjd tk¡p vkSj efgyk ds LokLF; ij foLr`r tkudkjh ysuh gksrh gSA ;fn vkj-Vh-vkbZ- gksus dk lansg gks] rks efgyk dks çtuu ekxZ dk laØe.k gS ;k ugha] ;g lqfuf’pr djus ds fy, yScksjsVªh tk¡p dk funZs’k fn;k tk ldrk gSA

;fn efgyk dks vkj-Vh-vkbZ- gS] rks vkS”k/kh; xHkZikr ds ç;ksx ds lkFk lkFk laØe.k ds fy, Hkh mldk mipkj gksxkA ;gh ckr ‘kY;fØ;k }kjk xHkZikr ij Hkh ykxw gksrh gSA vkS”k/kh; xHkZikr ;k ‘kY;fØ;k }kjk xHkZikr] fdlh ls Hkh igys vkj-Vh-vkbZ- mipkj ds iwjk gksus dh çrh{kk djus dk dksbZ dkj.k ugha gSA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr dks efgyk,a mldh fUkEufyf[kr fo’ks”krkvksa ds dkj.k pqurh gSa [11] [12] %

• fo’okl fd ;g lqjf{kr gS
• vf/kd LokHkkfod gS
• dksbZ phj&QkM+@csgks’kh ugha gksrh
• ,d ;k nksuksa nok,a ?kj ij yh tk ldrh gSa
• xHkZ ds vkjafHkd dky esa ç;ksx fd;k tk ldrk gS
• vklku vkSj lk/kkj.k gS

Top of the page

Mail to a friend

Print Version

xHkZ dks ,d xHkZ ijh{k.k ¼çsxusUlh VsLV½ }kjk fuf’pr fd;k tk ldrk gSA nks çdkj ds xHkZ ijh{k.k gksrs gSa & jDr vkSj ew= tk¡pA nksuksa ijh{k.k ,d fo’ks”k çdkj ds gkWjeksu dh tk¡p djrs gSa] Human Chorionic Gonodotrophine (hCG) tks dsoy xHkZorh gksus ij gh efgyk ds jDr vkSj ew= esa ik, tkrs gSaA ew= tk¡p çsxusUlh VsLV fdV }kjk ?kj ij gh dh tk ldrh gS] vkSj ;g fdV fdlh Hkh QkesZlh dh nqdku ij miyC/k gksrk gSA tcfd jDr tk¡p dsoy fdlh yScksjsVªh esa gh dh tk ldrh gS ¼ckWDl 3 ns[ksa½A

Top of the page

Mail to a friend

Print Version

vf/kdka’k ns’kksa esa] ?kj ij xHkZ ijh{k.k ¼çsxusUlh VsLV½ djus ds fy, fdV miyC/k gksrk gSA ;g ew= dh tk¡p gksrh gSA ;fn efgyk ds ?kj ij xHkZ ijh{k.k fdV dk ifj.kke ikWftfVo vkrk gS rks] mldk xHkZorh gksuk yxHkx fuf’pr gSA ;fn mldk ifj.kke usxsfVo gS] rks gks ldrk gS fd xHkZ lqfuf’pr djus ds fy, ;g vHkh cgqr tYnh gS D;ksafd ew= esa hCG dh ek=k vHkh dkQh de gSA ew= tk¡p esa xHkZ dk irk efgyk }kjk vafre ekgokjh u gksus ds ckn lIrkg ;k 10 fnuksa ds vanj yx tkrk gS [15] A

fdlh MkWDVj ;k nkbZ }kjk xHkZ dk irk dsoy efgyk dh vafre ekgokjh ds 6 lIrkg ckn isfYod tk¡p ls gh yxk;k tk ldrk gSA bl çdkj efgyk dks xHkZ lqfuf’pr djus ds fy, ml le; rd bartkj ugha djuk iM+rkA ;fn efgyk xHkZorh ugha gksuk pkgrh] rks og ekgokjh u vkus ij rqjar xHkZ Bgjus dh tk¡p djuk pkgsxh] vkSj xHkZikr djkus dh O;oLFkk djsxhA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr dk fodYi pquus okyh efgykvksa dks ekywe gksuk pkfg, fd os fdrus lIrkg ls xHkZorh gSaA ,slk blfy, fd gkyk¡fd feQsfçLVksu dh [kqjkd leku gh jgrh gS] ysfdu xHkZ dh fofHké voLFkkvksa esa felksçksLVy dh [kqjkd cny tkrh gSaA
xHkZ dk le; irk yxkus ds fy, vkerkSj ij fuEufyf[kr rjhdksa dk ç;ksx fd;k tkrk gS%

&efgyk dh vafre ekgokjh ds igys fnu ds ckn ls ftrus fnu Åij gks x, gSa mudh x.kuk djukA dbZ lkjh efgyk,a gj ekgokjh ds igys fnu dks dSys.Mj ij vafdr djrh gSa rkfd t:jr iM+us ij mls nksckjk ns[k ldsaA

&LokLF; çnkrk }kjk isfYod tk¡p djokukA vafre ekgokjh ds igys fnu ls djhc 6 lIrkg ds ckns ,d vuqHkoh çnkrk xHkZ fdrus le; dk gS ;g vkadyu dj ldrk@rh gSA

vYVªklksuksxzkQh dk ç;ksx fd;k tk ldrk gS ;fn%

&  efgyk viuh vafre ekgokjh dh rkjh[k ds ckjs esa Bhd ls u tkurh gks]

&  xHkZikr ;k çlo ds ckn nksckjk ekgokjh vkjaHk gq, cxSj og xHkZorh gks xbZ gks] ;k

&  LokLF; lsok çnkrk }kjk isfYod tk¡p ds ckn Hkh xHkZ ds le; ds ckjs esa la’k; gksA

vYVªklksuksxzkQh ls xHkZ FkSyh ¼tsLVs’kuy lSd½ dk vkdkj vkSj ckn dh xHkkZoLFkk esa] Hkzw.k dh yEckbZ Hkh ukih tk ldrh gSA

Top of the page

Mail to a friend

Print Version

4&9 lIrkg ds xHkZ esa vkS”k/kh; xHkZikr ds fy, fuEUkfyf[kr nok dh [kqjkdksa ¼jsftesul~½ dh lykg nh tkrh gS%

Top of the page

Mail to a friend

Print Version

9&13 vkSj 13&24 lIrkg ds xHkksZa ds fy, feQsfçLVksu@felksçksLVy dh [kqjkdsa vyx gksrh gSaA
9 lIrkg ls vf/kd ds xHkZ esa vkS”k/kh; xHkZikr dk ç;ksx vLirky ;k Dyhfud esa fpfdRlh; ns[kjs[k esa fd;k tkuk pkfg, D;ksafd blesa leL;kvksa dk tksf[ke c<+ tkrk gSA
9&13 vkSj 13&24 lIrkg ds xHkksZa ds vkS”k/kh; xHkZikr ds fy, nok dh fuEufyf[kr [kqjkdsa crkbZ xbZ gSa [5]%

Top of the page

Mail to a friend

Print Version

tgk¡ feQsfçLVksu miyC/k ugha gksrh] mu LFkkuksa ij dHkh dHkh 9 lIrkg ls Åij ds xHkZ ds vkS”k/kh; xHkZikr ds fy, dsoy&felksçksLVy ç;ksx fd;k tkrk gS] ysfdu vHkh Hkh nok dh lcls vf/kd lqjf{kr vkSj çHkko’kkyh [kqjkd ij Ik;kZIr tkudkjh ugha gSA

9 lIrkg ls Åij ds xHkZ esa dsoy&felksçksLVy ç;ksx djus esa lko/kkuh dh vko’;drk gksrh gSA xHkZ dk le; c<+us ds lkFk lkFk felksçksLVy dh [kqjkd de dh tkuh pkfg,] D;ksafd xHkkZ’k; çksLVkXySfMax ¼prostaglanding½ ds çfr cgqr laosnu’khy gks tkrk gS] fo’ks”kdj xHkZ/kkj.k ds 16 lIrkg ds ckn] vkSj ftu efgykvksa esa igys ds fltsfj;u ds ?kko gkas] muesa xHkkZ’k; ds QVus dk tksf[ke gksrk gS [2]A

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr dh çHkko’khyrk dks LFkkfir xHkkZsa dh njksa }kjk ekik tk ldrk gSA 9 lIrkg rd ds xHkksZa esa] vkS”k/kh; xHkZikr ds fy, feQsfçLVksu@;ksfu esa felksçksLVy dh [kqjkdksa dk ç;ksx djus okyh efgykvksa esa yxHkx dsoy 1% dk xHkZ cuk jgrk gS] vkSj 3 ls 5% esa] xHkZikr iwjk ugha gksrk ¼18½A laiw.kZ xHkZikr dh nj rc de gksrh gS tc 7 lIrkg rd ds xHkksZa ds fy, feQsfçLVksu@[kkus okyh felksçksLVy ¼400 ekbØksxzke½ [kqjkdksa dk ç;ksx fd;k tkrk gSA ,d v/;;u esa] feQsfçLVksu vkSj 800 ekbØksxzke felksçksLVy ;ksfu esa ysus ij laiw.kZ xHkZikr dh nj 96% Fkh vkSj bldh rqyuk esa] feQsfçLVksu ds ckn 400 ekbØksxzke [kkus okyh felksçksLVy ç;ksx fd;s tkus ij ;g nj 84% Fkh [19]A

çHkko’khyrk xHkZ ds dky ij fuHkZj djrh gS % xHkZdky ftruk vf/kd gksrk gS laiw.kZ xHkZikr dh nj mruh de gksrh gS vkSj xHkZ cus jgus dh laHkkouk nj mruh vf/kd gksrh gSA mnkgj.k ds fy,] 9&13 lIrkg ds xHkZ ds nkSjku vkS”k/kh; xHkZikr ¼ç’u 3 esa crkbZ xbZ [kqjkdksa ds lkFk½ ij fd, x, ,d cM+s v/;;u esa] 96% efgykvksa us laiw.kZ xHkZikr dk vuqHko fd;k ¼20½A 13&20 LkIrkg ds xHkZ esa vkS”k/kh; xHkZikr ls yxHkx 5% dk xHkZ cuk jg ldrk gS [18]A

dsoy&felksçksLVy ds lkFk lQyrk dh nj dkQh uhph vkSj vf/kd vfLFkj gSA 9 lIrkg rd ds xHkZ esa] cus jgus okys xHkZ dh nj 10&15% ds chp gksrh gS [21] A 9 lIrkg ls Åij ds xHkksZa esa çHkko’khyrk dh dh njksa ds çek.k vHkh miyC/k ugha gSaA

Top of the page

Mail to a friend

Print Version

tc 9 lIrkg rd ds xHkZ esa] xHkZikr ds fy, feQsfçLVksu@felksçksLVy dk rjhdk ç;ksx fd;k tkrk gS] rks dqN ?kVukvksa esa ¼2&3% efgykvksa esa½] efgyk feQsfçLVksu ysus ds ckn vkSj felksçksLVy ç;ksx djus ls igys xHkZ fu”dkflr dj nsrh gSA ckdh dh djhc 90% efgykvksa esa] laiw.kZ xHkZikr felksçksLVy ç;ksx djus ds 4&6 ?kaVksa ds vanj gksrk gS [5]A

9 lIrkg ds xHkZ ds ckn] xHkZ dk le; ftruk vf/kd gksxk] laiw.kZ xHkZikr gksus esa mruk yEck le; yxsxk ¼18] 20½A ,d v/;;u esa] igys tUe ns pqdh efgykvksa esa laiw.kZ xHkZikr gksus esa yxHkx 6 ?kaVs yxs vkSj ftuds igys çlo ugha gq, gSa mu efgykvksa esa 8 ?kaVs yxsA 70% ls vf/kd efgyk,a mlh fnu ?kj okil ykSV xbZa [22]A

xHkZ ds le;] [kqjkd vkSj nok nsus ds rjhds ds vk/kkj ij] dsoy&felksçksLVy ls 9 lIrkg rd ds xHkZ ds xHkZikr ds fy, crk, x, vko’;d le; esa cgqr ifjorZuh;rk gSA ,d v/;uu esaa lkeus vk;k fd 800 ekbØksxzke dh ;ksfud felksçksLVy dh ,d ;k nks [kqjkd ysus ds 24 ?kaVksa ds vanj Øe’k% 72% vkSj 86% efgykvksa dk xHkZikr laié gqvk [23]A

Top of the page

Mail to a friend

Print Version

v/;;uksa ls irk pyrk gS fd 9 lIrkg rd ds xHkZ esa feQsfçLVksu@felksçksLVy ds lqjf{kr ç;ksx dks lqfuf’pr djus ds fy, nks ckj Dyhfud tkuk i;kZIr gksrk gS] vkSj 9 lIrkg ls Åij ds xHkZ esa rhu ckj Dyhfud tkus dh vko’;drk gksrh gSA

tc feQsfçLVksu@felksçksLVy dks feyk dj ç;ksx fd;k tkrk gS

9 lIrkg ds rd ds xHkZ esa

Ikgyh ckj Dyhfud tkus ij

LokLF; lsok çnkrk

• efgyk dks lykg nsrs gSa vkSj le>krs gSa
• efgyk ds ckjs esa ;g tkuus ds fy, foLr`r tkudkjh ysrs gSa] fd mldh dksbZ ,slh fpfdRlh; voLFkk rks ugha gS tks vkS”k/kh; xHkZikr dks mlds fy, vuqi;qDr cukrh gS
• xHkZ dk le; fuf’pr djus ds fy, efgyk ls iwNrs gSa fd mldh vafre ekgokjh dh igyh rkjh[k dc Fkh vkSj rFkk tuukaxksa dk laØe.k u gks ;g ns[kus ds fy, isfYod tk¡p djrs gSaa ¼;fn laØe.k gks rks mldk mipkj fd;k tkrk gS½
• ;fn foLr`r fpfdRlh; tkudkjh vkSj isfYod tk¡p ls xHkZ dk lgh le; fuf’pr ugha gks ik jgk gks rks vYVªklkmaM Hkh dj ldrs gSa
• efgyk dks [kkus ds fy, feQsfçLVksu dh xksyh nsrs gSa
• efgyk dks fodYi nsrs gSa fd og felksçksLVy ;k rks ?kj ij ys ldrh gS ;k fQj felksçksLVy fpfdRlh; ns[kjs[k esa ysus ds fy, okil Dyhfud vk ldrh gS
• ;fn efgyk felksçksLVy ?kj ij ysus dk fu.kZ; djrh gS] rks LokLF; lsok çnkrk efgyk dks lsok çnkrk efgyk dks nokbZ dh nqdku ls felksçksLVy [kjhnus ds fy, funsZ’k fy[k dj ns ldrs gSaA ] 800 ekbØksxzke felksçksLVy dh [kqjkd ¼200 ekbØksxzke dh 4 xksfy;ka½ ;ksfu esa j[kus ds fy,] ;k feQsfçLVksu ysus ds 24&48 ?kaVs ckn] ?kj ij ysus ds fy, 400 ekbØksxzke felksçksLVy dh [kqjkd ¼200 ekbØksxzke dh 2 xksfy;ka½ nsrs gSa
• felksçksLVy ysus ds ckn tks nnZ vkSj ,saBu gksrh gS mlls fuiVus ds fy, efgyk dks nnZ fuokjd nok nsrs gSa

nwljh ckj Dyhfud tkus ij ¼;fn efgyk felksçksLVy Dyhfud esa ysus dk fu.kZ; djrh gS½

nwljh ckj Dyhfud] igyh ckj Dyhfud tkus ds 24 vkSj 48 ?kaVksa ds chp tkuk pkfg, ¼4½A bl eqykdkr ds nkSjku felksçksLVy ;ksfu esa j[kh tkrh gS ¼9 LkIrkg rd ds xHkZ essa½ ;k [kkbZ tkrh gS ¼7 lIrkg rd ds xHkZ essa½A

dbZ fLFkfr;ksa esa] efgyk dks 4&6 ?kaVksa ds fy, Dyhfud esa fuxjkuh ds fy, j[kk tkrk gSA bl le; ds nkSjku] 90% ls vf/kd efgykvksa us xHkZ ds mRikn fu”dkflr dj fn, gksrs gSa ¼5½A

;fn fuxjkuh okys le; ds nkSjku xHkZikr laié ugha gksrk] rks efgyk dks ?kj tkdj xHkZikr djus dh vuqefr ns nh tkrh gSA

dqN LFkkuksa ij] felksçksLVy LokLF; lsok çnkrk }kjk nh tk ldrh gS vkSj efgyk rqjar ?kj okil tk ldrh gSA ,sls ekeys esa] efgyk dks ;g tkuus dh vko’;drk gksrh gS fd xHkZikr mlds ?kj igq¡pus ls igys Hkh gks ldrk gSA

QkWyksvi ds fy, Dyhfud tkuk

lHkh efgykvksa dks feQsfçLVksu ysus ds 14 fnuksa ckn okil vkus ds fy, dgk tkrk gSA ,slk ;g ns[kus ds fy, fd;k tkrk gS fd xHkZikr iwjh rjg laié gks x;k gS ;k ugha vkSj xHkZ ds mRikn iwjh rjg fu”dkflr gks x, gSaA
bl eqykdkr ds nkSjku] LokLF; lsok çnkrk%

• xHkZ lekiu dh rqf”V djus ds fy, ‘kkjhfjd tk¡p djrs gSa
• ‘kkjhfjd tk¡p ds ckn ;fn la’k; gks rks] xHkZ lekiu dks lqfuf’pr djus ds fy, xHkZ tk¡p ¼çsxusUlh VsLV½ ;k vYVªlkmaM djrs gSa
• ;fn xHkZikr iwjk ugha gqvk gS] rks efgyk dks ;k rks dqN vkSj fnuksa ckn okil vkus ds fy, dgrs gSa D;ksafd rc rd xHkZikr iwjk gks tk,xk] ;k fQj vkSj felksçksLVy nssrs gSa] ;k xHkZikr iwjk djus ds fy, ‘kY;fØ;k dh çfØ;k djrs gSaA

9 lIrkg ls vf/kd le; ds xHkZ

,sls ekeyksa esa] dsoy ;gh varj gS fd Dyhfud de ls de rhu ckj tkuk gksrk gSA efgyk Dyhfud esa  igyh ckj vkus ds 24&48 ?kaVs ckn nksckjk Dyhfud vkrh gS] tc mlus feQsfçLVksu fy;k gksrk gSA felksçksLVy LokLF; lsok çnkrk }kjk Dyhfud esa nh tkrh gSA

bl eqykdkr ds nkSjku] felksçksLVy ;ksfu esa j[kh tkrh gS] mlds ckn nok dh dbZ lkjh vfrfjDr [kqjkdas ;ksfu }kjk vkSj@;k [kkus ds fy, rc rd nh tkrh gSa tc rd fd xHkZikr laié ugha gks tkrkA efgyk }kjk xHkZ ds mRiknksa dks fu”dkflr djus ds ckn mls dbZ ?kaVksa rd uxjkuh esa j[kk tkrk gSA

blds ckn] tSlk fd Åij crk;k x;k gS] QkWyksvi ds fy, cqyk;k tkrk gSA

tc dsoy&felksçksLVy ç;ksx dh tkrh gS

9 LkIrkg ls de ds xHkZ essa] [kqjkd dk rjhdk xHkZikr laié gksus rd ckj ckj ;ksfu }kjk ;k thHk ds uhps j[k dj felksçksLVy nsuk gksrk gSA bldk vFkZ] fLFkfr ds vuqlkj] iwjs fnu Dyhfud esa jguk ;k ?kj ij felksçksLVy dh [kqjkd ckj ckj ysuk gks ldrk gSA

Top of the page

Mail to a friend

Print Version

9 LkIrkg rd ds xHkZ essa] feQsfçLVksu vkSj felksçksLVy ds ?kj ij ç;ksx esa vlqj{kk dk dksbZ dkj.k ugha gS] c’krsZ efgyk dks ;g irk gks] fd dkSu lh efgyk nok ys ldrh gS vkSj dkSu lh ugha ys ldrh] mlds fofHké rjhdksa ds fy, [kqjkd] nq”ifj.kke ,oa leL;kvksa ds ckjs esa iwjh tkudkjh gks vkSj t:jr iM+us ij fpfdRlk ns[kHkky ij igq¡p miyC/k gksA 9 LkIrkg rd ds xHkZ ds ckn] feQsfçLVksu@felksçksLVy ds ?kj ij ç;ksx dh lykg ugha nh tkrh] ml le; vkS”k/kh; xHkZikr ds fy, ,d ;ksX; fpfdRld dh ns[kjs[k ç;ksx djuk egRoiw.kZ gksrk gSA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr ç;ksx djus okyh efgyk dks ekgokjh dh rjg ,saBu] isV esa nnZ vkSj jDrlzko dk vuqHko gksxkA vf/kdrj efgykvksa esa] felksçksLVy ysus ds ckn ,d ?kaVs ls lkr ?kaVksa ds chp xHkkZ’k; esa ,saBu vkSj ;ksfu ls jDrlzko ‘kq: gks tkrk gSA ysfdu dqN 5% efgykvksa esa feQsfçLVksu ysus ds igys ls gh ,saBu ‘kq: gks tkrh gSA

xHkZikr ds le; jDrlzko ekgokjh ds jDrlzko ls vf/kd gksrk gS vkSj xHkZ ds mRikn fu”dkflr gksrs gSaA ;g Hkkjh jDrlzko FkksM+s le; ds fy, jgrk gS] djhc 1&4 ?kaVs rdA gYdk jDrlzko vkSj /kCcs 9&13 fnuksa rd tkjh jgrs gSaA dqN cgqr gh de ekeyksa esa] xHkZikr gksus ds ckn efgyk dks 45 fnuksa rd gYdk jDrlzko vuqHko gks ldrk gS [4]A jDrlzko dh ek=k xHkZ dh vof/k vkSj ç;ksx dh xbZ nok ij fuHkZj djrh gSA

cgqr lkjh efgyk,a bl çfØ;k dh rqyuk LokHkkfod xHkZikr ls djrh gSaA efgykvksa dks jDr ds FkDds] Ård ;k xHkZ ds mRikn Hkh fn[kkbZ ns ldrs gSa [24] A

efgykvksa dks nLr] eryh] mYVh] ljnnZ] pDdj] ihB esa nnZ vkSj Fkdku tSls vU; nq”çHkkoksa dk vuqHko gks ldrk gSA ;s nq”çHkko felksçksLVy ysus ds ckn gksrs gSa ysfdu dsoy 2&4 ?kaVs gh jgrs gSaA dbZ lkjs v/;;uksa us n’kkZ;k gS fd felksçksLVy [kkus dh rqyuk esa ;ksfu esa j[kus ij eryh] mYVh vkSj nLr de gksrs gSa [24] A

Top of the page

Mail to a friend

Print Version

jDrlzko

• efgykvksa dh ,d NksVh la[;k esa dsoy feQsfçLVksu ysus ckn jDrlzko vkjaHk gks tkrk gSA lSfuVjh iSM ¼nqdku ls [kjhns gq, ;k ?kj esa cuk, gq,½ ds lkFk rS;kjh djds tkuk csgrj gSA
• ,slh fLFkfr;ksa esa tgk¡ felksçksLVy ysus ds fy, efgyk dks LokLF; dsanz esa nksckjk tkuk iM+rk gS] ogk¡ efgyk dks fQj ls lSfuVjh iSM ds lkFk rS;kjh djds tkuk pkfg, D;ksafd ?kj igq¡us ds igys mls jDrlzko ‘kq: gks ldrk gSA
• ,slk laHko gS fd dqN efgyk,a yEcs le; rd jDrlzko jgus dh fLFkfr esa nqdku ls lSfuVjh iSM [kjhnus esa leFkZ u gksa] ,sls esa ;g egRoiw.kZ gS fd efgyk ?kj esa cus iSM dks /kks,a vkSj /kwi esa lq[kk,a vkSj iSM xhyk gksrs gh xhsysiu ls vlqfo/kk eglwl gksus ij rqjar mls cny ysaA

nnZ

• efgykvksa }kjk vUkqHko dh tkus okyh ,saBu vkSj nnZ ifjorZuh; gksrk gSA ,d frgkbZ vkSj nks&frgkbZ ds chp efgykvksa dks dsoy gYdk nnZ vuqHko gksrk gS vkSj mUgsa nnZ fuokjd nok ysus dh vko’;drk Hkh ugha iM+rhA vU; efgykvksa dks ekgokjh ds leku rst ,saBu vuqHko gks ldrh gSA
• ;fn efgyk dks iSny ;k lkoZtfud ;krk;kr ls okil ykSVuk gS rks LokLF; dsanz esa fdlh ,sls O;fDr ds lkFk tkuk csgrj gksxk tks rst nnZ ;k ,sasBu gksus ij mldh lgk;rk dj ldsA
• Tkc ?kj esa gksa] rks nnZ ls vkjke ikus ds fy, efgyk ysV ldrh gS ;k lqfo/kkuqlkj cSB ldrh gSA og laxhr lqu dj] Vh-oh- ns[k dj] nksLrksa@ifjokj ds lnL;ksa ls ckrsa djds] xquxqus ikuh ls ugk dj vkjke eglwl dj ldrh gS] ;k nnZ ls vkjke ikus ds fy, isV ij xeZ ikuh dh FkSyh ;k iSM ls lsad dj ldrh gS [11]A
• efgyk igyh ;k nwljh ckj Dyhfud tkus ds le; LokLF; lsok çnkrk }kjk nh xbZ nnZ fuokjd nok Hkh ys ldrh gSA bUgsa funsZ’kkuqlkj fy;k tkuk pkfg,A ;fn dksbZ nnZ fuokjd nok fy[k dj ugha nh xbZ gS] rks og fcuk iphZ ds feyus okyh iSjkflVkeksy tSlh nok ys ldrh gSA

eryh] mYVh vkSj nLr

• ;fn eryh] mYVh ;k nLr ‘kq: gks tk,a rks gYdk [kkuk [kkus vkSj vf/kd ls vf/kd rjy inkFkZ ysus ls lgk;rk feysxhA ;fn ;s y{k.k xaHkhj gks tk,a vkSj efgyk ds isV esa [kkuk u #d jgk gks rks] mls mYVh vkSj nLr ij fu;a=.k dh nok ds fy, LokLF; lsok çnkrk ls laidZ djuk pkfg, [11]A
• ;fn felksçksLVy [kkus ds vk/ks ?kaVs ds vanj efgyk mYVh djrh gS] rks mls nwljh [kqjkd ysuh gksxhA

‘kjkc vkSj nokvksa dk lsou

• feQsfçLVksu@felksçksLVy ysus ds ckn de ls de xHkZikr laié gksus rd] ‘kjkc vkSj u’khyh nokvksa dk lsou ugha djuk pkfg,A

;fn vki vU; dksbZ ufnZ”V nok ;k fcuk&funsZ’k dh nok ;k tM+h&cwVh ;k dksbZ vU; vkS”kf/k feJ.k ¼cukbZ xbZ nok,asa ½ ys jgh gSa rks vkS”k/kh; xHkZikr ds fy, tkus ls igys LokLF; lsok çnkrk ls lykg ysuk egRoiw.kZ gSA ;s nok,a vkSj vkS”kf/k feJ.k feQsfçLVksu dh çfrfØ;k dks çHkkfor dj ldrs gSa [25]A

Top of the page

Mail to a friend

Print Version

Hkkjh ;k vR;f/kd jDrlzko

;fn xHkZikr v/kwjk jg x;k gks rks Hkkjh jDrlzko dk tksf[ke gksrk gSA dqN LokLF; lsok çnkrk] ‘kY;fØ;k }kjk xHkZikr djus ls igys Hkkjh jDrlzko dk feFkjftu ¼Methergin½ uke dh nok ls mipkj djrs gSaA 9 lIrkg rd ds xHkZ esa vkS”k/kh; xHkZikr ç;ksx djus okyh efgykvksa esa yxHkx 1% efgykvksa dks bldh vko’;drk iM+rh gS[11]A

cgqr de ?kVukvksaa esa] efgyk dks xHkkZ’k; ds vR;f/kd jDrlzko dk vuqHko gks ldrk gSA ,slk Hkkjh jDrlzko vkerkSj ij nok,a nsus ds 1&3 lIrkg ds ckn gksrk gS ¼felksçksLVy ysus ds ckn gksus okys jDrlzko ds vykok½A
efgyk dks irk py tk,xk fd jDrlzko dkQh vf/kd gks jgk gS] ;fn

• ,d ?kaVs ds vanj nks eksVs lSusVjh iSM xhys gks tk,a] vkSj
• ,slk yxkrkj nks ?kaVs rd gks] vFkkZr mls 2 ?kaVs esa pkj iSM~l bLrseky djus iM+sa

1000 efgykvksa esa ls 1 efgyk dks brus vf/kd jDrlzko dk vuqHko gksrk gS fd mUgsa jDr p<+kus dh vko’;drk gksrh gS [16]A

;fn efgyk dks bruk Hkkjh jDrlzko gks rks mls fcuk nsj fd, vius LokLF; lsok çnkrk ls laidZ djuk pkfg,A bl chp] mls vf/kd ek=k esa rjy inkFkZ ysus pkfg, rkfd mlds ‘kjhj ls vfuok;Z [kfut fu”dkflr u gksaA
laØe.k
B.M yxuk vkSj gYdk lk rkieku vkerkSj ij felksçksLVy ysus ds rqjar ckn gks tkrk gSA ;s nok ds nq”çHkko gSa laØe.k ds y{k.k ugha] vkSj vkerkSj ij dsoy nks ?kaVksa rd gh jgrs gSa [11]A

vkS”k/kh; xHkZikr ds ckn 1% ls Hkh de efgykvksa esa laØe.k ns[kk x;k gS [26]A laØe.k dk lansg gks ldrk gS] ;fn

• efgyk dks 100-4 F ¼38-0° C½  cq[kkj gks tk, vkSj 4 ?kaVs ls vf/kd le; rd jgs] ;k
• vxj efgyk }kjk felksçksLVy ysus ds 6 ls 8 ?kaVksa ds ckn cq[kkj ‘kq: gksA

;fn efgyk esa ;s y{k.k gksa rks mls fpfdRlh; lgk;rk ysus dh vko’;drk gS [11]A laØe.k dh xaHkhjrk vkSj fuxjkuh rFkk vkxs tk¡p dh vko’;drk ds vuqlkj] mldk mipkj ,d ckgjh jksxh ¼vkmV is’ksUV½ ds rkSj ij djds mls ?kj Hkstk tk ldrk gS] ;k mipkj ds fy, varjax jksxh ¼bu is’ksUV½ ds rkSj ij vLirky esa nkf[ky djus dh vko’;drk gks ldrh gSA

Top of the page

Mail to a friend

Print Version

Lku~ 2001 vkSj 2005 ds chp] vkS”k/kh; xHkZikr ds ckn vejhdk esa pkj vkSj dukMk esa gqbZ ,d e`R;q gky gh esa fpfdRlh; vkSj eq[;/kkjk dh ehfM;k esa ys[kksa o i=ksa dk fo”k; cuhaA bUgsa DykslVªhfMve lksjMsyh ¼Clostridium sordellii½ uke ds ,su,jksfcd cSDVhfjve ¼anaerobic bacterium½ ds laØe.k ds lkFk tksM+k x;k( vkS”k/kh; xHkZikr nokvksa dks mudk dkj.k ugha crk;k x;kA ekpZ 2006 esa] vejhdk esa vkS”k/kh; xHkZikr ds ckn nks vfrfjDr e`R;q dh ?kVuk,a lkeus vkbZ FkhaA buesa ls ,d e`R;q esa DykslVªhfMve lksjMsyh ¼Clostridium sordellii½ tSlh fo’ks”krk,a gSa( vkSj nwljh dks yxrk ugha fd xHkZikr ds lkFk fcYdqy Hkh tksM+k x;k gSA

DykslVªhfMve lksjMsyh ¼Clostridium sordellii½ feV~Vh esa ik;k tkus okyk ,d chtk.kq gSA bu e`R;qvksa esa ;g dSls vkSj D;ksa tqM+k] ;g vHkh rd le>k ugha tk ldk gSA ;s e`R;q,a D;ksa gqbZ vkSj buds dkj.kksa ij ,oa bUgsa dSls jksdk tk ldrk gS & bl ij fjlpZ ‘kq: gks pqdh gSA ekStwnk vkadM+ksa dh leh{kk djus ds fy, ebZ 2006 esa] fo’k”kKksa dh ,d Vhe dh cSBd vejhdk esa vk;ksftr dh tk,xhA gkyk¡fd] buesa ls fdlh Hkh e`R;q esa ,slk dksbZ çek.k ugha gS tks bl ckr dk dksbZ ladsr ns fd laØe.k dk dkj.k feQsfçLVksu ;k felksçksLVy FkhA

,slk Kkr gS fd çlo vkSj xHkZikr ds ckn efgykvksa esa DykslVªhfMve lksjMsyh ¼Clostridium sordellii½ ls tkuysok laØe.k gq, gSaA  ;s laØe.k vkSj lkFk gh lkFk vkS”k/kh; xHkZikr ds ckn tks laØe.k gksrs gSa] cgqr gh de gksrs gSaA vejhdk] LohMu] ;w-ds- vkSj vU; cgqr lkjs ns’kksa esa felksçksLVy ;ksfu }kjk nsuk ,d ekud çFkk jgh gSA vU; ns’kksa esa] felksçksLVy fof’k”V :i ls [kkus ds rkSj ij nh tkrh gSA fQj Hkh] ,slk dksbZ çek.k ugha gS tks ;g ldsar djrk gS fd felksçksLVy nsus dk laca/k DykslVªhfMve lksjMsyh ¼Clostridium sordellii½ ls gq, laØe.k ls gSA

blds vykok] vejhdk ls ckgj vkt rd vkS”k/kh; xHkZikr ç;ksx djus okyh 30 yk[k ¼3 fefy;u½ ls vf/kd efgykvksa esa Hkh DykslVªhfMve lksjMsyh ¼Clostridium sordellii½ ls laØe.k ugha ik;k x;k gSA phu esa] tgk¡ 2 djksM+ 20 yk[k ¼22 fefy;u½ ls vf/kd efgykvksa usa vkS”k/kh; xHkZikr ç;ksx fd;k gS] ogk¡ Hkh bl laØe.k dh dksbZ [kcj ugha vkbZ gS] gkyk¡fd vkadM+s lhfer gSaA

xHkZikr ,d lcls lqjf{kr fpfdRlh; çfØ;k gSA ;g ;kn j[kuk egRoiw.kZ gS fd xHkZikr tc fdlh çf’kf{kr lsok çnkrk }kjk fd;k tkrk gS rks tfVyrkvksa dk tksf[ke cgqr gh de gksrk gSA bl {ks= esa dk;Z djus okys lHkh yksxksa ds lkFk] vkbZ-lh-,e-,- dh lapkyu lfefr ¼LVh;fjax desVh½ bu e`R;qvksa ds ckjs esa fpafrr gSA fQj Hkh] vkS”k/kh; xHkZikr ds Js”B lqj{kk fjdkMZ ds vk/kkj ij gekjs }kjk bldk leFkZu tkjh gSA ge vkxs ds fodkl dh djhc ls fuxjkuh dj jgs gSa vkSj fdlh Hkh miyC/k ubZ tkudkjh dks vkbZ-lh-,e-,- dh osclkbV nsuk tkjh j[ksaxs¼[33] [34] [45] [36]½A

Top of the page

Mail to a friend

Print Version

efgyk dks lansg gks ldrk gS fd xHkZ vHkh Hkh gS] ;fn

• vkS”k/kh; xHkZikr dh nok ysus ds ckn dksbZ jDrlzko u gks ;k dsoy cgqr de jDrlzko gks
• mls xHkZ ds y{k.k vuqHko gksrs jgsa

fpfdRlh; ns[kjs[k ds varxZr] efgyk dks ges’kk feQsfçLVksu ysus ds 14 fnuksa ds ckn QkWyksvi eqykdkr ds fy, nksckjk Dyhfud vkus ds fy, dgk tkrk gSA LokLF; lsok çnkrk iqf”V djrs gSa fd xHkZikr laié gqvk gS ;k ugha vkSj D;k vkxs mipkj dh vko’;drk gSA ;fn lansg dk dksbZ Hkh dkj.k gks fd xHkZ vHkh Hkh dk;e gS] ;k xHkZikr iwjh rjhds ls ugha gqvk gS] rks chVk ,plhth ¼beta hCG½ jDr tk¡p vkSj@;k vYVªklkmaM tk¡p dh tk ldrh gSA
;g egRoiw.kZ gS fd efgyk LokLF; lsok çnkrk ls lykg djsA ;fn xHkZ Bgjk gqvk gS rks LokLF; lsok çnkrk felksçksLVy dh vkxs vkSj [kqjkd ns ldrs gSaA ;fn efgyk mlh le; xHkZ lekiu djuk pkgrh gS] rks mlds LokLF; lsok çnkrk dks tYn ls tYn ‘kY;fØ;k }kjk xHkZikr dh O;oLFkk djuh pkfg,A

Top of the page

Mail to a friend

Print Version

feQsfçLVksu@felksçksLVy ;k dsoy&felksçksLVy ç;ksx ds ckn Hkh tks xHkZ cus jgrs gSa muesa ls vf/kdka’k esa iSnk gksus okyk f’k’kq lkekU; gh gksxkA gkyk¡fd] tUetkr foÑfr;ksa ds tksf[ke dks tkapus ds fy, fd, x, dqN v/;;uksa esa ;g fu”d”kZ ik;k x;k gS fd felksçksLVy ç;ksx djus ds ckn tUesa f’k’kqvksa esa iSnkb’kh foÑfr;ksa dk tksf[ke FkksM+k vf/kd gks ldrk gSA buesa ls vf/kdka’k foÑfr;ka dsanzh; Luk;q&ra= vkSj Åijh vkSj fupys vaxksa ¼ central nervous system and lower and upper limbs½ ls lacaf/kr gksrh gSa 21]A feQsfçLVksu ds dkj.k iSnkb’kh foÑfr;ka ugha gksrh 4]A

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr gksus ds ckn] efgyk dks nok ysus ds ,d lIrkg ckn rd ;k tc rd og rS;kj u ellwl u djs] rc rd ;ksfu }kjk lsDl esa layXu ugha gksuk pkfg, ;k viuh ;ksfu esa dqN Hkh ugha Mkyuk pkfg, [3]A

Top of the page

Mail to a friend

Print Version

;fn efgyk us xHkZfujks/k dk çHkko’kkyh mik; ugha viuk;k rks og viuh igyh ekgokjh ls igys Hkh xHkZorh gks ldrh gSA efgyk ds ekgokjh pØ dh vof/k ds vk/kkj ij] vkS”k/kh; xHkZikr ds ckn 10 fnuksa ls ysdj nks lIrkg ds vanj xHkZ Bgj ldrk gS [3]A

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr ds pkj ls Ng lIrkg ckn efgyk dh lkekU; ekgokjh gks ldrh gS] c’krsZ og nksckjk xHkZorh u gqbZ gks [3]A

Top of the page

Mail to a friend

Print Version

felksçksLVy ysus okys fnu ls gh efgyk xHkZfujks/k dk ç;ksx vkjaHk dj ldrh gSA xHkZfujks/kd xksfy;ka] gkWjeksu okys batsD’ku vkSj beIykaVl~ mfpr mik; gks ldrs gSaA xHkZfujks/k dh vojks/kd fof/k;ka tSls dkWuM~e] xHkZfujks/kd tSyh ;k Qkse] ljokbdy dSi vkSj MkbvWÝSe iqu% ;kSfud laHkksx vkjaHk djrs le; ç;ksx dh tk ldrh gSaA ;fn efgyk baVªk ;wVªjkbu fMokbl~ ¼vkbZ-;w-Mh-½ yxokuk pkgrh gS] rks mls xHkZikr iwjk gksus vkSj xHkZ ds lkjs mRikn fu”dkflr gks tkus rd çrh{kk djuh gksxh [11]A

tgk¡ rd vkS”k/kh; xHkZikr ds ckn ulcUnh dh ckr gS] mlesa dksbZ çfrca/k ;k fojks/k ugha gS] vkSj ;g çfØ;k xHkZikr ds ckn] vFkkZr xHkZ ds mRikn fu”dkflr gks tkus ij fdlh Hkh le; dh tk ldrh gSA gkyk¡fd] O;ogkj esa] tks efgyk,a ulcUnh djokuk pkgrh gSa os ‘kk;n ‘kY;fØ;k }kjk xHkZikr djokuk pkgsaxh] rkfd nksuksa çfØ;k,a ,d ckj csgks’kh djus ij gh gks tk,aA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr ds efgyk ds LokLF; ij dksbZ Kkr gkfudkjd nwjxkeh çHkko ugha gSaA ;g mlds thou ls vupkgs xHkZ dk ruko gVk dj mldh [kq’kgkyh esa ldkjkRed ;ksxnku ns ldrk gS [11]A

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr Hkfo”; esa efgyk dh çtuu {kerk ;k larku dh mRifŸk dks çHkkfor ugha djsxk [11]A phu ds ,d v/;;u esa] ftlesa ,d vkS”k/kh; xHkZikr ds ckn efgyk ds okafNr xHkkZsaa rFkk muds ifj.kkeksa dh tkap dh xbZ] dksbZ gkfudkjd çHkko ugha ik;k x;k [30]A gky gh esa ,u-bZ-ts-,e- esa çdkf’kr ,d cM+s v/;;u esa ckn dh tuu {kerk ;k xHkZ ifj.kkeksa ij dksbZ gkfudkjd çHkko lkeus ugha vk;k gS [38]

Top of the page

Mail to a friend

Print Version

dksbZ nh?kZdkfyd v/;;u ugha fd, x, gSa ftUgksausa bl eqn~ns dh tkap&iM+rky dh gksA

Top of the page

Mail to a friend

Print Version

vkS”k/kh; xHkZikr dh dher fuEufyf[kr ds vk/kkj ij lkjs ns’kksa esa vyx vyx gksrh gS%

• feQsfçLVksu dh dher
• felksçksLVy dh dher
• feQsfçLVksu vkSj felksçksLVy dh ç;ksx dh xbZ [kqjkdsa ¼xksfy;ksa dh la[;k½
• Dyhfud }kjk lykg@ijke’kZ dh dher
• xHkZ ijh{k.kksa dh dher
• vYVªklkmaM dh dher ¼;fn fd;k x;k gks½

xHkZikr iwjk djus ds fy, ;fn ‘kY;fØ;k }kjk pw”k.k ¼,slfijs’ku½ dh vko’;drk gqbZ vkSj leL;kvksa ds mipkj ds fy, Dyhfud ds vfrfjDr nkSjs vfuok;Z gq, rks mldh dhersa vfrfjDr gks ldrh gSaA
fQj Hkh] orZeku esa lkjs fo’o esa] vkS”k/kh; xHkZikr dh dher dk eq[; Hkkx feQsfçLVksu dh dher gSA
lu~ 2005 rd fofHké ns’kksa esa feQsfçLVksu dh QqVdj dhersa fuEufyf[kr Fkha [31]%

• ;w-,l-,-                                  250 ;w,l Mkyj ¼600 mg½
• teZuh] fLoVt+jyS.M               130&140 ;w,l Mkyj ¼600 mg½
• ;w-ds                                    75 ;w,l Mkyj ¼600 mg½
• phu] Hkkjr] fo;ruke                6&8 ;w,l Mkyj ¼200 mg½

QqVdj feQsfçLVksu yxHkx lHkh fLFkfr;ksa esa [kjhnus dh lkeF;Z ds vanj gksrh gS] gkyk¡fd dsoy&felksçksLVy ç;ksx djus okyh efgykvksa dks dgha vf/kd xksfy;ksa dh vko’;drk gksrh gSA mnkgj.k ds fy,] tc felksçksLVy dh ,d 200 ekbØksxzke dh xksyh vLirky vkSj ykblsal çkIr LokLF; dsanzksa ls yh tkrh gS rks ;w-ds- esa bldh dher 0-30 ;w,l Mkyj vkSj nf{k.k vÝhdk esa yxHkx 0-50 ;w,l Mkyj gksrh gS [31]A
efgyk ds fy, vkS”k/kh; xHkZikr dh okLrfod dher bl ckr ij Hkh fuHkZj djrh gS fd xHkZikr lsokvksa dk [kpZ fdl çdkj fn;k tk jgk gS] vkSj D;k vkS”k/kh; xHkZikr lkoZtfud foŸk O;oLFkk ;k ches ds varxZr ‘kkfey gSaA

Top of the page

Mail to a friend

Print Version

dkSu us ns’kksa esa feQsfçLVksu dks ykblsal çkIr gS vkSj mu ns’kksa dk ekufp= tgk¡ felksçksLVy ekU;rk çkIr gS] budh foLr`r lwph ns[kus ds fy, http://gynuity.org/resources/info/map-of-misoprostol-approval/ ij ykWx vkWu djsaA

Top of the page

Mail to a friend

Print Version

gj efgyk dks vupkgs xHkZ dks lqjf{kr :i ls lekIr djus dk vf/kdkj gksuk pkfg,A dbZ dkj.k gSa ftudh otg ls efgyk xHkZ dks lekIr djkuk pkg ldrh gSA gks ldrk gS xHkZ ;kSfud vk?kkr ;k tcjnLrh ;kSu dk ifj.kke gks( efgyk vc xHkZ u j[kuk pkgrh gks D;ksafd xHkZorh gksus ds ckn ls mldh fLFkfr esa ifjorZu vk x;k gS( lkekftd vkSj vkfFkZd ifjfLFkfr;ka mls xHkZ j[kus dh vuqefr u ns jgh gksa( xHkZfujks/kd foQy gqvk gks( fdlh çHkko’kkyh xHkZfujks/kd mik; ij efgyk dh igq¡p u gks( ;k mls xHkZ/kkj.k ls cpus ds ckjs esa dksbZ tkudkjh u gksA

nqHkkZX; ls] cgqr ls ns’kksa esa xHkZikr dkuwuh rkSj ij çfrcaf/kr gSA pwafd lqjf{kr xHkZikr lsok,a miyC/k ugha gSa] cgqr lh efgyk,a xHkkZ’k; esa dksbZ uqdhyh oLrq Mkydj ;k tM+h&cwfV;ksa okyh nokvksa ls] ;k isV ij ncko Mkydj ;k tM+h&cwfV;ksa dk dk<+k ihdj xHkZikr djus dk ç;kl djrh gSaA cgqr lh ?kVukvksa esa] buls xaHkhj #X.krk ;k e`R;q Hkh gks ldrh gSA

vf/kdka’k ns’kksa esa tgk¡ xHkZikr dkuwuh :i ls çfrcaf/kr gS] cgqr laHkkouk gS fd ogk¡ feQsfçLVksu iathÑr gksxhA ijarq felksçksLVy yxHkx lHkh ns’kksa esa O;kid :i ls miyC/k gS D;ksafd ;g xSfLVªd vYlj ds mipkj ds fy, iathÑr gSA

felksçksLVy nok dh nqdku ds dkamVj ls [kjhn dj ç;ksx djuk ySfVu vejhdk vkSj dSjsfcvu esa dkQh çpfyr gS vkSj ,f’k;kbZ ns’kksa esa ;g la[;k c<+ jgh gSA czkthy vkSj fpyh tSls ns’kksa ds vuqHko ls irk pyrk gS fd vkS”k/kh; xHkZikr mu vkØked fodYiksa ls lqjf{kr gS ftudk ç;ksx xHkZikr çsfjr ¼bu~M;wl½ djus ds fy, efgykvksa dks etcwju djuk iM+rk FkkA  gkyk¡fd nq”ifj.kke gSa] ysfdu yxHkx ges’kk bUgsa lkekU; nokvksa ls laHkkyk tk ldrk gS [2]A

xHkZikr iwjk djus ds fy, ?kj ij felksçksLVy ç;ksx djus ds ckn LokLF; lsok dsanz esa crkus ls fdlh Hkh laHkkfor leL;k dk le; ij çca/k djus esa vklkuh gksrh gSA xHkZikr ij dkuwuh :i ls çfrca/k okys ns’kksa esa jgus okyh efgykvksa dks xHkZikr dh ges’kk tksf[ke okyh fof/k;ksa ds LFkku ij felksçksLVy ,d egRoiw.kZ fodYi nsrk gSA

Top of the page

Mail to a friend

Print Version

[1] - Winikoff B. Global overview of medical abortion. Presentation at Medical Abortion: An International Forum on Policies, Programmes and Services, 17-20 October 2004, Johannesburg.

[2] - Shannon CS, Winikoff B. (editors). Misoprostol: An emerging technology for women’s health. Report of a seminar. New York, Population Council, 2004.

[3] - www.medicalabortion.org/questions/work.html, referred on 25 May 2005

[4] - World Health Organization. Safe abortion: Technical and policy guidelines for health systems. Geneva, WHO, 2003.

[5] - Royal College of Obstetricians and Gynaecologists. The Care of Women Requesting Induced Abortion. National Evidence-Based Clinical Guidelines. London: RCOG, September 2004. Summary at: <http://www.rcog.org.uk/womens-health/clinical-guidance/care-women-requesting-induced-abortion>. Accessed 27 October 2005.

[6] - Mifiprex (mifepristone) medication guide. http://www.fda.gov/cder/drug/infopage/mifepristone/default.htm. Referred on 15 June, 2005.

[7] - Information on ectopic pregnancy from http://www.medicinenet.com/ectopic_pregnancy/article.htm. Referred on 10 June, 2005.

[8] - Hill NC, Selinger M, Ferguson J et al. The placental transfer of mifepristone during the second trimester and its influence upon maternal and fetal steroid concentrations. British Journal of Obstetrics and Gynaecology, 1990, 97:406-411.

[9] - Vogel D, Burkhardt T, Rentsch K et al. Misoprostol versus methylergometrine: pharmacokinetics in human milk. American Journal of Obstetrics and Gynecology, 2004, 191:2168-2173.

[10] - de Bruyn M. Safe abortion for HIV-positive women with unwanted pregnancy: A reproductive right. Reproductive Health Matters, 2003; Vol.11 No. 22: 52-61.

[11] - Gynuity. Providing medical abortion in developing countries: An introductory guidebook. New York, Gynuity Health Projects, 2004.

[12] - Berer M. Medical abortion: Issues of choice and acceptability. Reproductive Health Matters 2005;13(26):25-34):

[13] - Ganatra B. Contrasts and Common Ground: The Context of Abortion in Asia. Presentation at Medical Abortion: An International Forum on Policies, Programmes and Services, 17-20 October 2004, Johannesburg, South Africa

[14] - Elul B, Peralman E, Sorhaindo A, et al. In-depth interviews with medical abortion clients: Thoughts on the method and home administration of Misoprostol. Journal of the American Medical Women’s Association Volume 55, no. 3 supplement 2000 pp 169-172.

[15] - Information on pregnancy tests from www.4woman.gov/faq/pregtest.htm, referred on 10 June, 2005.

[16] - www.medicationabortion.org/questions/index.html referred on 15 May, 2005 with inputs from ICMA Steering Committee members and reviewers.

[17] - von Hertzen H, Nguyen H, Piaggio G, et al. Comparison of two routes and two intervals of administration of misoprostol for the termination of early pregnancy: a randomised multicentre trial. Interim results (unpublished)

[18] - Clinical Guidelines: medical abortion 13–20 weeks. London: bpas, 2005.

[19] - Schaff EA, Fielding SL, Westhoff C. Randomized trial of oral versus vaginal misoprostol 2 days after mifepristone 200mg for abortion up to 63 days of pregnancy. Contraception 2002;66:247-50

[20] - Hamoda H, Ashok PW, Flett G, et al. Medical abortion at 9–13 weeks' gestation: a review of 1,076 consecutive cases. Contraception 2005;71:327–32.

[21] - Consensus Statement: Instructions for use – Abortion induction with misoprostol in pregnancies up to 9 weeks LMP. Expert Meeting on misoprostol sponsored by Reproductive Health Technologies Project and Gynuity Health Projects. July 28, 2003, Washington D.C.

[22] - Fiala C, Swahn ML, Stephansson O, et al. The effect of non-steroidal anti-inflammatory drugs on medical abortion with mifepristone and misoprostol at 13-22 weeks gestation. Human Reproduction 2005;Aug 11 (Abstract only, e-publication).

[23] - Jain JK, Dutton C, Harwood B et al. A prospective randomized, double-blinded, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Human Reproduction 2005;17(6):1477-1482.

[24] - http://www.plannedparenthood.org/index.htm referred on 2 June, 2005.

[25] - US Food and Drug Administration. FDA Alert for Healthcare Professionals: Mifepristone (marketed as Mifeprex), 22 July 2005. At: <http://www.fda.gov/cder/drug/InfoSheets/HCP/MifepristoneHCP.pdf> and <http://www.fda.gov/cder/drug/infopage/mifepristone/mifepristone-qa20050719.htm>. Accessed 29 August 2005.

[26] - Shannon C, Brothers LP, Philip NM, et al. Infection after medical abortion: a review of the literature. Contraception 2004;70:183–90.

[27] - Fischer M, Bhatnagar J, Guarner J et al. Fatal toxic shock syndrome associated with clostridium sordellii after medical abortion. New England Journal of Medicine 2005;353: 2352-2360.

[28] - Greene MF. Fatal infections associated with mifepristone-induced abortion. New England Journal of Medicine 2005;353: 2317-2318.

[29] - Grimes DA. Risk of mifepristone in context [Commentary]. Contraception 2005;71:161.

[30] - Chen A, Yuan W, Meirik O et al. Mifepristone-induced early abortion and outcome of subsequent wanted pregnancy. American Journal of Epidemiology 2004;160(2):110-117.

[31] - www.gynuity.org, referred on 7 February 2006.

[32] - Von Hertzen H, Piaggio G, Nguyen Thi My Huong, et al. Efficacy of two intervals and two routes of administration of misoprostol for termination of early pregnancy: a randomized controlled equivalence trial. Lancet 2007;369:1938-46.

[33] - US Food and Drug Administration. FDA Public Health Advisory Sepsis and Medical Abortion Update 17 March 2006. At: http://www.fda.gov/cder/drug/advisory/mifeprex200603.htm

[34] - US Food and Drug Administration. FDA Alert for Healthcare Professionals: Mifepristone (marketed as Mifeprex), 22 July 2005. At: www.fda.gov/cder/drug/InfoSheets/HCP/MifepristoneHCP.pdf and www.fda.gov/cder/drug/infopage/mifepristone/mifepristone-qa20050719.htm

[35] - Fischer M et al. Fatal toxic shock syndrome associated with clostridium sordellii after medical abortion. New England Journal of Medicine 2005;353:2352-2360.

[36] - Greene MF. Fatal infections associated with mifepristone-induced abortion. New England Journal of Medicine 2005;353:2317-2318.

[37] - Grimes DA. Risk of mifepristone in context [Commentary]. Contraception 2005;71:161

[38] - Jasveer Virk, M.S., M.P.H., Jun Zhang, Ph.D., M.D., and Jørn Olsen, M.D., Ph.D.Medical Abortion and the Risk of Subsequent Adverse Pregnancy Outcomes. New England Journal of Medicine, Volume 357:648-653, August 16,2007, Number 7