终止10～16周妊娠方法的回顾性研究

Retrospective Study on Methods of Termination of 10-16 Weeks Pregnancy

目的:回顾性分析本院33年来妊娠10-16周住院引流产病例,评价终止10～16周妊娠的方法。方法:随机选择本院1975～2007年妊娠10～16周住院引流产妇女515例,对其一般情况、引流产方法、引流产时间及效果进行分析。结果:随着年代递近,引产者年龄变轻、未产妇比例增长(P<0.01);妊娠时间和孕产次缩短(P<0.01)。终止10～16周妊娠的引产方法从原始的天花粉结晶蛋白引产、水囊引产、钳刮术和依沙吖啶引产逐渐转变为米非司酮配伍前列腺素引产,后者产程短、引产成功率高、出血量较少。水囊和依沙吖啶引产方法失败率较高;天花粉引产时间最长;水囊钳刮方法产后出血发生率最高。结论:终止10～16周妊娠以米非司酮配伍前列腺素引产方法更安全有效,其清宫率比较高,尚需进一步探讨。

Objective： To retrospectively analyze the hospitalized abortion cases with 10 - 16 weeks gestation from 1975 to 2007, and evaluate the methods of termination of 10 - 16 weeks pregnancy. Methods： 515 hospitalized abortion cases with 10 - 16 weeks gestation were selected randomly from 1975 to 2007. The general state of health, methods, time and effects of induced labor were analyzed. Results： With the era growing, the age of abortion applicants became younger, the rate of nullipara was higher （P〈0.01）, the average gestational weeks and parity were shorter （P〈0.01）. The methods of pregnancy termination transformed from original trichosanthin, water bag, curettage and ethacridine induced labor into mifepristone with prostaglandin induction of labor, which had advantages of shorter labor, higher success rate and less amount of intrapartum hemorrhage. The failure rates of water bag and ethacridine induced labor were relatively higher, the intrapartum of trichosanthin induced labor was the longest, and the incidence of postpartum hemorrhage in water bag curettage was the highest. Conclusion： The mifepristone with prostaglandin induction of labor is a safer and more effective for termination of 10 - 16 weeks pregnancy with its higher rate of uterine curettage, while its related mechanisms are needed further exploration.