米非司酮配伍米索前列醇用于晚期妊娠引产的效果观察

LabourInductioninWomenatTermwithMifepristoneandMisoprostol

目的：探讨米非司酮配伍米索前列醇在晚期妊娠引产中的作用。方法：对６８例妊娠３８～４１＋周的正常孕妇有引产指征者，分别在１～３日服用米非司酮１５０～２００ｍｇ，并于用药前后观察宫颈长度及宫颈评分的变化，同时检测血清雌二醇（Ｅ２）及孕酮（Ｐ）的水平。第４日分次加服米索前列醇１００～３００μｇ，观察引产效果。结果：服用米非司酮后宫颈缩短１～３ｃｍ，Ｂｉｓｈｏｐ评分提高了４～５分。Ｅ２明显升高（Ｐ＜０．０１），Ｐ显著下降（Ｐ＜０．００１），与用药前比较，均有显著性差异。宫颈成熟有效率达１００．００％，引产成功率为９２．１０％～９３．３３％，阴道分娩率为８０．８８％。结论：应用米非司酮配伍米索前列醇进行晚期妊娠引产，显示出有效。

Objective:Todeterminetheefficacyofmifepristone(RU486)combinedwithmiso-prostolasaninductionagentfortheinitiationoflabourinwomenatterm.Methods:Ourstudygroupcontained68pregnantwomenatterm(gestationalage:38～41weeks)whohadclearclinicalindicationsforlabourinduction.Theyreceivedmifepristoneeither150mgor200mgrespectivelyinthefirsttwoorthreedays.Theshorteningofthecervicallength,thechangeofBishopscoreandthechangeofthebloodseruminoestradiol(E2)concentrationandprogesterone(P)concentrationwereobservedrespectivelybeforeandaftermedication.Onthefourthday,misoprostolwasaddedfrom100μgto300μgsuccessively.Theoutcomeoflabourinductioninthesewomenwasrecorded.Re-sults:Thecervicallengthofwomenwhoweregivenmifepristonewas1～3cmshorterandBishopscorewas4～5higherthanthosebeforeteatment.TheE2concentrationandthePconcentrationweresignificantlyhigherandlowerrespectivelythanthosebeforeteatment.Thecervicalripeningratiowas100.00%.Theincidenceoftheonsetoflaborwas93.00%andtheincidenceofvaginalydeliv-erywas80.88%aftermisoprostonwasgiven.Conclusion:Mifepristonecombinedwithmisoprostolisasafe,efficient,economicalandconvenientinductionagentforinitiationoflaborinwomenatterm.