米非司酮合并米索前列醇终止高危早孕388例临床观察

Clinical Study on the Termination of 388 High - risk Early Pregnancies with Joint Use of Mifepristone and Misoprostol

研究目的:研究停经70天以内的高危人流对象早孕药流的安全性、有效性及可接受性.对象和方法:疤痕子宫、生殖道畸形、子宫肌瘤、近期人流、多次人流、哺乳期妊娠等高危人流对象388例,停经34～69天,口服米非司酮25mgq12h×5次,首次剂量50mg(总量150mg),第3天上午口服米索前列醇600μg.结果:完全流产率92.3%,不全流产率 6.2%,失败率1.5%.结论:口服米非司酮合并米索前列醇能有效地终止高危人流对象早孕,其效果与一般人群药流效果相似,其安全性、有效性和可接受性令人满意.此外,由于用药后宫颈软化、宫口扩张,即使药流失败也易于吸宫术的施行,减轻受术者的痛苦.

Purpose:To investigate the safety,effectiveness and acceptability of the termination of high risk pregnancies (less than 70 days)with mifepristone and misoprostol. Subjects and Methods: 388 high - risk pregnant women with the scarred uterus,or reproductive tract malformation,or myoma, or histories of recent abortion or repeated abortions,or during lactation;pregnancies lasting 34 ~ 69 days following last menstrual period. All subjects were administered orally 150 mg mifepristone (25mg×5,with 50 mg at the first time) and 0. 6 mg misoprostol in the morning of third day. Results:The rate of complete abortion was 92. 3% ,while that of incomplete abortion 6. 2% and that of failure 1. 5%. Conclusion : It was showed that the joint use of mifepristone and misoprostol could be used effectively to induce abortions of those high -risk pregnancies. Its effectiveness for high -risk population was similar to that for ordinary population. Its safety,effectiveness and acceptability were satisfying. In addition,the cervix became softer and dilated and it is easier and less painful to have D&.C for those subjects who failed to abort.