“Draft:Dr Hazem El-Refaey”的意思、由来-开放百科全书

Hazem El-Refaey is an Egyptian-British Obstetrics and Gynaecology specialist, holding several patents in the field of pregnancy and childbirth. El-Refaey has pioneered several treatments to minimise complications during miscarriage, abortion and childbirth^[1] ^[2] . Primarily, El-Refaey is credited for having spearheaded the use of the prostaglandin agent misoprostol in obstetrics and gynecology, which has been described as the “penicillin of reproductive health” ^[3] .

Education and Career

El-Refaey was born in 1957 in Cairo, Egypt. After graduating from Cairo University in 1981, El-Refaey moved to the United Kingdom, and has since practiced across the country, including Glasgow, Aberdeen,and London. El-Refaey was admitted to the Royal College of Obstetrics and Gynaecology in 1990 and obtained his MD degree from Aberdeen University in 1994.

El-Refaey has practiced at London’s UCL and Imperial College School of Medicine, and has worked at Chelsea and Westminster Hospital for over 15 years. He proposed and led the development of the Early Pregnancy Unit at Chelsea and Westminster Hospital, which was officially opened in 2005^[4].

Misoprostol and pioneering drug use

Developed in the 1980s, Misoprostol had typically been used to prevent gastric ulcers as oral tablets. Misoprostol is a hormone-like drug that can stop the secretion of stomach acid. El-Refaey proposed that the drug could work similarly on the uterus, making the muscle tissues contract, and as a result stemming bleeding ^[5] .

El-Refaey’s research spearheaded multiple other uses for misoprostol relating to women’s health and post-partum mortality. El-Refaey's introdution of misoprostol in Obstetrics and Gynaecology has been described as "nothing short of a revolution in reproductive health care".’^[6]

Miscarriage, Stillbirth and Abortion

While working on his postdoctoral thesis as Aberdeen University, El-Refaey found that misoprostol could be administered vaginally, as well as orally. He established a safe dose for abortion, and showed that taking misoprostol as a follow up to mifepristone, made the highly controversial abortion pill RU-486 more effective ^[7]. El-Refaey’s suggestions were published in the New England Journal of Medicine in 1995,^[8]. Following the publication, and through a series of studies, it was established that El-Refaey’s proposals, not only made the RU-486 more effective, but also more tolerable and accessible to women^[9].These findings were further confirmed by two large studies published by the World Health Organization Research Group on Post‐Ovulatory Methods for Fertility Regulation,^[10] ^[11].

Whilst misoprostol is better known as an ‘abortion pill’^[12], El-Refaey also found that misoprostol could clear the uterus after a miscarriage and stillbirths, inducing contractions and sparing women from multiple examinations and invasive prodecures to clear the uterus.

These protocols were adopted by professional bodies across the globe, including the RCOG, ACOG, and have become standard practice around the world.

Post-Partum Haemorrhage

Postpartum Haemorrhage is a leading cause of maternal death globally. El-Refaey also idenitfied that misoprostol could be used in the prevention and treatment of post partum haemorrhage ^[13] ^[14] . As misoprostol is cheap, and does not need refigeration, is is considered ideal for women in developing countries, unlike the typical injection given to women in highly developed nations ^[15]. As a result, Misoprostol was added to the World Health Organization’s Essential Medicine for Postpartum Haemorrhage ^[16] ^[17] ^[18]in 2011. Misoprostol today is used rectally to combat post partum haemorrhage around the world today.

References

1. ^[https://www.chelwest.nhs.uk/professionals/find-a-consultant/hazem-el-refaey] Chelsea and Westminster Hospital
2. ^[https://www.doctify.co.uk/specialist/mr_hazem_el_refaey] Doctify
3. ^[Henderson,C.E, El-Refaey, H and Potts, M [https://www.glowm.com/pdf/PPH_2nd_edn_Chap-33.pdf"Misoprostol in Practice"], p287, 2012, The Global Library of Women's Medicine
4. ^[https://www.chelwest.nhs.uk/professionals/find-a-consultant/hazem-el-refaey Chelsea and Westminster Hospital]
5. ^[https://www.sfgate.com/health/article/WOMEN-S-HEALTH-Collateral-Damage-Why-can-t-we-2517844.php Why can't we prevent more childbirth deaths? Blame abortion politics] SFGATEJanet Wells, Sunday, June 4, 2006,Retrieved on 3 April 2019’
6. ^[https://academic.oup.com/bmb/article/67/1/205/330398]["Post-partum haemorrhage: definitions, medical and surgical management. A time for change"], British Medical Bulletin' Volume 67, Issue 1, December 2003, Pages 205–217',.Retrieved on 4 April 2019.’
7. ^ El-Refaey, H & Templeton A [https://www.contraceptionjournal.org/article/0010-7824(94)90085-X/fulltext]], Contraception, February 1994 Volume 49, Issue 2, Pages 111–114
8. ^ El-Refaey Hazem et al. [https://www.nejm.org/doi/10.1056/NEJM199504133321502/"Induction of Abortion with Mifepristone (RU 486) and Oral or Vaginal Misoprostol"], The New England Journal of Medicine, 13 April 1995 332:983-987. Retrieved on 4 April 2019.
9. ^ Abraham, Carolyn. [https://www.theglobeandmail.com/news/world/when-health-and-moral-values-collide/article4322958/"When Health and Moral Values Collide"], The Globe and Mail, 25 June 2010. Retrieved on 4 April 2019.
10. ^[https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.2004.00153.x BJOG: an International Journal of Obstetrics and Gynaecology] WHO multinational study of three misoprostol regimens aftermifepristone for early medical abortion. I: Efficacy, Honkanen, H et al, 2003,Vol. 110, pp. 808–818]]
11. ^[https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.2004.00153.x BJOG: an International Journal of Obstetrics and Gynaecology] WHO multinational study of three misoprostol regimensafter mifepristone for early medical abortion.II: Side effects and women’s perceptions, Honkanen, H et al, 2 July 2004, Vol. 111, pp. 715 –725]]
12. ^[https://www.plannedparenthood.org/learn/abortion/the-abortion-pill/how-does-the-abortion-pill-work]Planned Parenthood]]’
13. ^Maternal mortality across the world BBC News Jane Hughes 26 October 2009 Retrieved on:1 April 2019]
14. ^[https://www.ncbi.nlm.nih.gov/pubmed/9699753 Rectally administered misoprostol for the treatment of postpartum hemorrhage unresponsive to oxytocin and ergometrine: a descriptive study.] O'Brien, P El-Refaey, H et al, Obstet Gynecol. 1999
15. ^"BBC"
16. ^[https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/misoprostol/en/ WHO Statement regarding the use of misoprostol for postpartum haemorrhage prevention and treatment]
17. ^ [https://www.who.int/selection_medicines/committees/expert/20/applications/Misoprostol_PPH.pdf PROPOSAL FOR THE INCLUSION OF MISOPROSTOLIN THE WHO MODEL LIST OF ESSENTIAL MEDICINES]
18. ^ [https://www.chelwest.nhs.uk/professionals/find-a-consultant/hazem-el-refaey Chelsea and Westminster: Hazem El-Refaey]