米非司酮与依沙吖啶终止剖宫产术后妊娠观察

Effects of mifepristone combined with ethacridine on termination of pregnancy after cesarean section

目的 观察米非司酮联合依沙吖啶终止剖宫产术后妊娠的临床效果及安全性.方法 选择剖宫产术后妊娠15-24周要求终止妊娠的妇女125例,随机分成观察组（75例）与对照组（50例）.两组均经腹壁羊膜腔注射依沙吖啶100mg,观察组同时口服米非司酮4次,总量为150mg.观察两组引产效果及安全性.结果 观察组注药至出现规律宫缩时间（26.72±6.85小时 vs 35.98±8.62小时;u=6.37,P〈0.05）及产后2小时出血量（170.60±67.23mL vs 139.20±47.64mL;u=2.86,P〈0.05）明显低于对照组.观察组未出现先兆子宫破裂或子宫破裂,对照组有2例出现先兆子宫破裂,两组比较无显著性差异（直接概率P=0.16）.观察组用药期间无明显不良反应.结论 米非司酮联合依沙吖啶终止剖宫产术后妊娠时间短、产后出血少,可在严密监护下应用.

Objective To observe the clinical effect and safety of mifepristone combined with ethacridine on terminating pregnancy after cesarean section. Methods 125 patients, who were 15-24 weeks of gestational age after cesarean section and asked for abortion, were randomly divided into observation group （n = 75 ） and control group （n = 50）. Besides injection of 100mg Ethacridine as in control group, women in observation group administrated mifepriston for 4 times （orally total amount of 150mg）. Results In observation group, the lasting durations from injection to uterine contraction （26.72 ± 6.85h vs 35.98 ± 8.62h ; u = 6.37, P 〈 0.05 ） was remarkably shorter than that in control group, and the amount of postpartum hemorrhage within 2 hours in observation group was much less than that in control group （ 170.60 ± 67.23mL vs 139.20 ± 47.64mL; u = 2, 86, P 〈 0. 05 ）. Neither threatened uterine rupture nor rupture of uterus occurred in observation group, while there were two in control group suffering threatened uterine rupture. But the difference between two groups was not statistically significant （exact probability P = 0.16）. There was not serious side effect in observation group, Conclution Because of short duration and little postpartum bleeding, mifepriston in combination with ethacridine can be used to terminate pregnancy after cesarean section under close monitoring.