米非司酮联合乳酸依沙吖啶终止瘢痕子宫中期妊娠引产的探讨

Labour Induction in Midtrimester Cesarean Scar Pregnancy with Mifepristone and Rivanol

目的:观察米非司酮联合乳酸依沙吖啶终止瘢痕子宫中期妊娠引产的临床效果。方法:应用前瞻性研究方法将2007年1月至2009年10月瘢痕子宫中期妊娠引产患者87例分二组:第一组47例为观察组,应用米非司酮联合乳酸依沙吖啶羊膜腔内注射引产;第二组40例为对照组,应用安慰剂联合乳酸依沙吖啶羊膜腔内注射引产,比较两种方法的临床效果和不良反应。结果:观察组和对照组相比:两组引产成功率差异无统计学意义(P>0.05),但观察组相对对照组宫缩发动时间短,排胎时间短,产后出血发生率低,胎盘胎膜残留率低,无软产道裂伤,差异有统计学意义(P<0.05)。结论:米非司酮联合乳酸依沙吖啶提高了瘢痕子宫中期妊娠引产的安全性,有效性,值得临床推广。

Objective： To determine the efficacy ofmifepristone combined with rivanol as an induction agent for the initiation of labour in midtrimester cesarean scar pregnancy. Methods： This prospective study contained 87 women of midtrimester cesarean scar pregnancy receiving labour induction from JAN 2007 to OCT 2009. Our study group contained 47 pregnant women. They received oral mifepristone combined with rivanol by amniotic injection ,The control group contained 40 pregnant women who received oral placebo combined with rivanol by amniotic injection. We assessed the outcome and complication between the two groups. Results： There was no difference in success rate between the control group and the study group. However ,in the study group, the initiation time of contraction and process were significantly shorter.The study group also has lower rate of bleeding and lower remaining rate of fetal membrane and placenta,without soft birth canal Conclusion： Mifepristone combined with rivaaol is a safe and efficient induction agent for initiation of labor in midtrimester cesarean scar pregnancy.