两种流产方法对再次妊娠孕产期并发症的影响

Comparative study on the effects of two different abortion methods on complications of repeated pregnancy during gestation and labor

目的探讨人工流产（以下简称人流）和药物流产（以下简称药流）对再次妊娠发生的孕产期并发症的影响。方法选择986例有药物流产史和968例有人工流产史的初产妇进行回顾性调查分析，分析其妊娠期和分娩期并发症的发生情况。结果妊娠期并发症人流组的先兆流产、前置胎盘、早产的发生率高于药物流产组，差异有统计学意义（P〈0．01或P〈0．05）。两组的妊娠高血压综合征，妊娠期贫血，死胎、过期妊娠等并发症的发生率差异无统计学意义（P〉0．05）；分娩期并发症人流组的胎盘残留、胎盘粘连、胎膜早破、产后出血、胎盘植入的发生率高于药流组，差异有统计学意义（P〈0．01或P〈0．05），两组胎儿窘迫的发生率差异无统计学意义（P〉0．05）；人流2次或2次以上的先兆流产、前置胎盘、产后出血、胎盘粘连、胎盘残留、胎盘植入的发生率均高于人流一次的，差异有统计学意义（P〈0．01或P〈0．05）。结论人流后再次妊娠的孕产期并发症发生率较药流明显增加，因此，一旦避孕失败，药流是比人流更加安全的补救措施。

Objective To investigate the effects of the drug abortion or induced abortion on com- plications of repeated pregnancy during gestation and labor. Methods Complications during labor in 986 women with drug abortion （ drug abortion group） and 968 women with induced abortion （ induced abortion group） were retrospectively analyzed. Results Threatened abortion of pregnant period rate, naturalness abortion rate and repetitive placenta rate were higher in manual work abortion than that in medicine abor- tion. The difference was significant （P 〈 0.01 or P 〈 0.05）. There was no significant difference be- tween the two groups in the incidences of pregnancy induced hypertension, anemia gravidarum, dead fetus or postterm pregnancy （P 〉 0.05）. In labor period, the incidences of residue of placenta, placenta adhesion, premature rupture of membranes, postpartum hemorrhage and placenta increta in the induced abortion group were significantlyhigher than those in the drug abortion group （P 〈 0. 01 or P 〈 0.05）, while there was no significant difference in the incidences of fetal distress between the two groups. The incidences of threatened abor- tion, placenta previa, postpartum hemorrhage, placenta adhesion, residue of placenta and placenta in- creta are all higher in those who have induced abortion two or more times than those who only do once. The difference was also significant （P 〈 0.01 or P 〈 0.05）. Conclusions The incidence of complica- tions of repeated pregnancy during gestation and labor after induced abortion is significantly higher than that of drug abortion. Therefore, once the contracepton fails, drug abortion is safer than induced abortion to terminate the pregnancy.