米非司酮配伍米索终止中晚期妊娠的效果观察

Labour induction in women at middle and term with mifepristone and misoprostol

目的探索米非司酮配伍米索终止中、晚期妊娠的效果。方法289例孕妇分为3组，孕13～16wk为Ⅰ组，孕16～27wk末为Ⅱ组，＞28wk为Ⅲ组。各组均在住院前第1、2天上午8时分别服米非司酮75mg，第3天上午8时住院服米索，首次剂量0．6mg，若无有效官缩，每小时加0.2mg,最大剂量≤16mg。结果组引产成功率分别为97．05％、93．16％、92．85％，3组间比较无显著性差异（P＞0．05）。各组服米索至胎儿排出的平均时间＜8h，规律宫缩至胎儿排出的平均时间＜5h。3组胎盘、胎膜残留率为32．53％，其中、Ⅱ、Ⅲ组占96．81％。立即清官者产后平均出血时间＜9d；未清宫者，产后平均出血时间＞32d。结论①米非司酮配伍米索用于中、晚期妊娠引产均有效。②中期妊娠引产胎盘、胎膜残留率较高，及时清宫是防止出血时间延长的有效措施。

Objective To evaluate the effcacy of mifepristone combined whith misoprostol as an induction agent forthe inihation of labour in Women at Middle and Term.Methods 289 pregnant women were divided into 3groups.Group 113~16 gestational weeks,group II16~27 gestational weeks,group Ⅲ≥28 gestational weeks.Each group was given separately mifepristone 75 mg at 8 a. m. before 1、2 day oing to hospital (total dose150mg), misoprostol was given at 8 a. m. of the day entering hospital, the for for tha first time was 0.6mg, ifeffective constricton of uterin did not be induced, the patient,was given again misoprostol 0. 2mg q. 1. h, themaximum of misoprostol was less than or equal to 1. 6mg. Results The are rate of labour induced in group I、Ⅱ all Ⅲ was respectively 97.05% 、93. 16% and 92.85%, it did not show any significant difference between the3 groups(P>0. 05). In each group, the average time from misoprostol given to delivery was shorter than 8hours, while the average time from asising regular uterine contrelivery was shorter than 5 hour . Therate of remains of placenta and membranes was 32.53% in 3 groups, while the rate of remains of group Ⅰ and Ⅱmade up 96.81% of tha total rate of remains.In cases with ermans of placenta and membranes,the average timeof uterine bleeding was shorter than 9 days by doing curettege at once affer delivery,while the average time ofuterine bleeding was longer that 30 daps for not doing cureffage at once affer delivery.ConclusionsMifepristone combined with misoprostol is and effcinet method for labour induction in women at middle and term.The rate of remains of placenta and membranes is higher at middle pregancy ,the curettage is an efficentmeasure for preventing prolonged utenine bleeding .