摘要
目的:通过对比两种终止孕16～24周妊娠方法的不同效果,旨在探讨终止孕16～24周妊娠的安全、可行、更为简便、高效的引产方法。方法:选择自愿要求终止且符合计划生育政策的孕16～24周而无禁忌证的妊娠妇女102例。随机分为两组,Ⅰ组米非司酮75mg(服药前后2小时空腹),每日2次,连服2天;第3天晨阴道置米索前列醇0.6mg,以后根据子宫收缩情况是否加用米索前列醇,最大剂量≤1.6mg。Ⅱ组口服米非司酮75mg,日2次或日4次(服药前后2小时空腹),总剂量150mg,并于首次口服米非司酮之日行依沙吖啶100mg羊膜腔内注射引产。观察两组宫缩的发动时间(即引流产时间)、总产程时间、软产道损伤情况、胎盘胎膜残留、产后出血量、引产成功率等情况。结果:两组引产成功率均为100%,在软产道损伤、胎盘胎膜残留、产后出血方面比较,差异无统计学意义(P>0.05)。Ⅰ组在引流产时间、总产程时间等方面优于Ⅱ组(P<0.05)。结论:米非司酮配伍米索前列醇用于孕16～24周妊娠引产是安全、可行及有效的。其操作较为简单方便并且可以加快产程进展,减少痛苦。
Abstract Objective ：To compare the effect of two different labor inductions and to deter-mine the safe, feasible, easy and efficient way for labor induction in 16 -24 weeks of gestation. Methods： 102 pregnant women （16- 24weeks of gestation） with willingness, seeking termination of gestation, complying with the population policy of China and without indication were selected in study and randomly assigned Ⅰ and Ⅱ groups.Ⅰ group： take Mifepristoue （ 75mg ） , before and after intake were on an empty stomach, BID for two days, then put misoprostol 0. 6mg into the vagina in the morning of the third day and increase the dose （Max 1. 6mg） according to the contractions of the uterus. Ⅱ group ： take Mifepristone （ 75mg ） , before and after intake were on an empty stomach ,BID or QID（ totally 150rag） ,at the same time of the first intake of mifepristone injected into amniotic cavity with Ethacridine to induce labor. To observe the related outcome measures including contraction （when to feel the contraction？） , stage of labor,injury of soft birth canal,the remains of placenta and fetal membranes, bleeding volume,the success rate of labor induction et. Results：The success rate of labor induction were 100% in both groups,cmnpared the injury of soft birth canal, remains of placenta and fetal membranes and bleeding volume, there was no significant difference （P 〉 0. 05）. but there was significant difference in the period of induction and total birth process between the two groups, group I was better than group Ⅱ （ P 〈 0. 05 ）. Conclusions： Combined use mifepristone and misoprostol is safe, feasible and efficient for labor induction in 16- 24 weeks of gestation, it can shorten the period of labor and relief the labor pain and easier for operation.
