瘢痕子宫中期妊娠引产临床分析

Analysis of Induced Abortion in Cases of Scarred Uterus Pregnancy.

目的探讨不同孕龄瘢痕子宫（均为子宫下段剖宫产术后）中期妊娠引产的治疗方法。方法对北京仁和医院在2005年1月~2009年3月的100例中期妊娠要求终止的有剖宫产史孕妇,分别在孕12-16周采用米非司酮联合米索前列醇法、孕16-28周采用依沙吖啶羊膜腔内注射法。选择同期非瘢痕子宫引产者100例,将引产方法相同的瘢痕子宫与非瘢痕子宫进行比较,观察其一般情况、宫缩至胎儿胎盘娩出时间、产后2h出血量、成功率及软产道裂伤情况。结果 100例剖宫产术后半年后妊娠的瘢痕子宫引产分别采用其上述2种方法。采用同种引产方法后,瘢痕子宫与非瘢痕子宫孕妇宫缩至胎儿胎盘排出时间、产后2h出血量、成功率从及软产道裂伤无差异显著性（P〉0.05）,无一例子宫破裂发生。结论术后半年以上中期妊娠的瘢痕子宫患者在严密观察下,在不同的孕期依沙吖啶羊膜腔内注射和米非司酮联合米索前列醇这两种引产方法是简单、安全、有效的。

Objective To study the ways for pregnancy termination of second trimester in a scarred uterus.Methods During 4-year period from January 2005 to March 2009,200 women of 12~28 weeks of gestation who underwent the second trimester termination of pregnancy were studied.One hundred patients with a scarred uterus underwent at least half a year one cesarean section were selected and 100 without a scarred urerus served as controls.Termination was undertaken by following methods： misoprostol and prostaglandin,rivanol intraamniotic.Results One hundrend scarred uterus pregnancy beyond six months after the previous caesarean section were terminated by the two methods.The two groups using the same method were similar in the time from induction to abortion,postpartum hemorrhage volume within 2 hours and the incident rate of cervicallaceration.No uterine rupture was observed.Conclusion Under the strict observation,the two inducing abortion methods are effective,safe and simple procedure for second trimester termination which beyond six months after operation in a scarred uterus.