米非司酮在晚期妊娠引产中的临床观察

Clinical Observation of Mifepristone in Late Pregnancy Labor Induction

目的:探讨米非司酮配合催产素在晚期妊娠引产的可行性。方法:选择笔者所在医院收治的晚期妊娠(即宫内妊娠28周后)有胎儿畸形、胎死宫内、胎膜早破合并胎死宫内羊水过少患者122例,研究组(62例)无论宫颈是否成熟均予米非司酮100 mg单次口服同时予催产素静脉滴注引产,对照组(60例)如宫颈未成熟予普拉睾酮静脉注射同时予催产素静滴引产,宫颈成熟直接予催产素静滴引产。24 h引产未成功研究组重复使用米非司酮100 mg单次口服,对照组宫颈未成熟重复使用普拉睾酮静脉注射,两组继续静脉滴注催产素催产直至胎儿娩出,对比不同宫颈成熟度下两组引产时间、使用催产素总量、产后出血量及软产道损伤情况。结果:两组122例患者均引产成功,宫颈成熟与未成熟两种情况下研究组引产时间、催产素使用量均优于对照组,差异有统计学意义(P<0.05),在宫颈Bishop评分、产后出血及软产道损伤方面,两组比较差异无统计学意义(P>0.05)。结论:米非司酮100 mg口服配合催产素静脉滴注在晚期羊水过少的畸胎及死胎引产,能有效缩短引产时间,不增加产后出血量及软产道的损伤,安全性高,值得基层医院推广应用。

Objective： To investigate the feasibility of mifepristone with oxytocin induction of labor in late pregnancy. Method： Select the author＇s hospital treated late pregnancy （intrauterine pregnancy after 28 weeks） with fetal malformation, fetal intrauterine fetal death, premature rupture of membranes merger intrauterine oligohydramnios, 122 cases of patients.The reasearch group （62 cases）, no matter whether the cervical mature to 100 mg of single oral mifepristone to oxytocin intravenous drip induced labor at the same time, the control group （60 cases）, such as cervical prasterone immature to intravenous to oxytecin static drop induced labor at the same time, the cervical mature to oxytocin static drop induced labor directly.24 h induced labor unsuccessful team repeated use 100 mg single oral mifepristone and control group in the cervical prasterone immature reuse intravenous injection, two groups of intravenous drip oxytocin oxytocin until fetal childbirth, compared two groups under different cervical maturity amount induced labor time, use of oxytocin, postpartum blood loss and soft birth canal injury. Result： Two groups of 122 patients were successfully induced labor, cervical mature and immature in both cases the team in induced labor time, oxytocin usage were superior to control group, the difference was statistically significant （P〈0.05） in cervical Bishop score, postpartum hemorrhage and soft birth canal injury, the more similar between the two groups had no statistical significance （P〉0.05）.Conclusion： Mifepristone combined with oxytocin might effectively shorten the labor induction time and improve the efficiency of labor induction without the increasing of the amount of postpartum hemorrhage and soft birth canal injury and be worthy of promotion.