米非司酮配伍米索前列醇终止不同孕周中期妊娠205例临床分析

Clinical analysis on the effect of the compatibility of mifepristone plus misoprostol to terminate midterm gestation

目的 探索米非司酮配伍米索前列醇终止不同孕周中期妊娠 (12～ 16周和 17～ 2 6周 )的效果及安全性。方法 将符合条件药物终止妊娠的妇女 2 0 5例 ,根据孕龄分成两组 ,给患者服用米非司酮 5 0mg ,12h1次 ,共 4次 ,总量 2 0 0mg ,第 3天阴道放置米索前列醇 0 .6mg ,每 12h重复 1次 ,最多 3次。 结果 两组的引产成功率分别为 98.2 0 %和 97.86 % ,两组单次米索前列醇用药的成功率分别是 82 .88%和 79.78% ,P >0 .0 5 ,胎盘排出时间与阴道出血的关系呈正比。胎盘排出 >30min者阴道出血量明显增多 (P <0 .0 5 )。结论 口服米非司酮 2 0 0mg合并阴道放置米索前列醇是终止 12～ 16周妊娠的较好方法 ,对妊娠 >16～ 2 6周的引产同样具有安全、成功率高的特点 ,值得推广 ,并建议对胎盘排出 >30min者及时清宫。

Objective To explore the effect and safety of the compatibility of mifepristone with misoprostol to terminate the gestation during the period of 12 to 16 weeks and 16.1 to 26 weeks of pregnancy. Methods Divide the whole group 205 pregnant women for termination of gestation into two groups according to their ages. Took orally 50 mg mifepriston every 12 hours, a total of four times then insert 0.6 mg misoprostol deep into vagina every 12 hours, a maximum of 3 times. Results The successful rates of induced labor were 98.2% and 97.86% respectively for both groups; the rates were 82.88% and 79.78% when misoprostol was used once only, ( P >0.05). Duration of placental discharge was proportionate to vaginal haemorrhage. When the duration of placenta discharge lasted more than 30 minutes, vaginal haemorrhage increased significantly, ( P >0.05). Conclusions Compatibility of 200 mg mifepristone (taken orally) plus misoprostol (vaginally) is an effective method to terminate gestation during the period of 12 to 26 weeks, and it is also proven to be a safe and successful method for induceing labor during the period of 16.1 to 26 weeks of pregnancy. Here we suggest an immediate womb clearance once the duration of placental discharge lasting for more than 30 minutes.(Shanghai Med J, 2000,23∶738-740)