米非司酮配伍米索前列醇终止瘢痕子宫中期妊娠的临床研究

Termination of Second Trimester Pregnancy with Mifepristone and Misoprostol in Patients with Scarred Uterus

目的:探讨米非司酮配伍米索前列醇终止瘢痕子宫中期妊娠的有效性和安全性。方法:回顾性研究瘢痕子宫(组1)和非瘢痕子宫(组2)中期妊娠引产各105例,比较米非司酮配伍米索前列醇终止瘢痕子宫中期妊娠的引产成功率、胎儿排出时间、胎盘滞留率及子宫破裂例数等。结果:2组引产成功率(分别为96.2%、94.3%)、排出时间(中位数均为5 h)、胎盘滞留率(分别为15.2%、7.6%)差异均无统计学意义。组1发生1例子宫破裂,组2未发生子宫破裂。结论:米非司酮配伍米索前列醇终止瘢痕子宫中期妊娠安全有效,但术前仍须全面评估,严密监测产程进展,警惕子宫破裂的发生。

Objective： To investigate the efficacy and safety of the termination of second trimester pregnancy with mifepristone and misoprostol in patients with previous cesarean section. Methods： 105 women with scarred uterins （group 1 ） due to previous cesarean and 105 matched patients （group 2） without uterine scar were retrospectively analyzed. They underwent termination of second trimester pregnancy with mifepristone and misoprostol. The success rate of abortion,the induction-to-delivery interval,the occurrence rate of retained placenta, uterine rupture and hemorrhage were compared. Results ：There were no significant differences in the abortion rate （96.2% vs. 94.3%）,the induction-to-delivery interval （both 5 h） and the retained placenta rate （15.2% vs. 7.6%） between the two groups （P〉0.05）. There was only one case of uterine rupture in the group 1. Conclusions：Mifepristone combined with misoprostol are safe and effective in the termination of second trimester pregnancy for those patients with scarred uterins. But during the termination of pregnancy,overall evaluation and careful monitoring are necessary.