摘要
目的:探索米非司酮配伍米索前列醇终止16~24周妊娠的最佳给药方案。方法:将来自上海市8所医院607例要求终止16~24周妊娠的妇女随机分为3组。组Ⅰ第1天晨口服米非司酮200mg,第3天晨阴道放置米索前列醇400μg,12h重复1次,最多3次;组Ⅱ第1天晨口服米非司酮100mg,连用2d,第3天阴道放置米索前列醇400μg,使用方法同组Ⅰ;组Ⅲ第1天晨口服米非司酮200mg,第3天晨口服米索前列醇400μg,每6h重复1次,最多4次。结果:3组流产成功率分别为97.1%、96.0%和92.0%,差异有统计学意义(χ2=6.05,P=0.048);流产成功577例,引流产时间为13.43±10.18h,3组间无统计学差异(F=1.01,P=0.36);流产成功者中,米索前列醇用量组Ⅰ、组Ⅱ、组Ⅲ分别为616.33±317.26μg、634.99±307.88μg、797.85±395.56μg,组III使用量高于组Ⅰ、组Ⅱ(F=16.20,P=0.00)。胎儿娩出后2h内和2~24h阴道流血量3组差异均无统计学意义。用药后主要不良反应为胃肠道不适,程度轻且无需特殊处理。结论:单次口服米非司酮200mg配伍米索前列醇,每12h阴道给药400μg,是终止16~24周妊娠的理想用药方案。
Objective: To investigate the optimal medical regimen for terminating pregnancy in 16-24 weeks of gesta- tion. Methods: This is a multi-center randomized controlled trail with 8 hospitals in Shanghai. A total of 607 women with pregnancy in 16-24w gestation were randomized into three groups. Group Ⅰ took mifepristone 200mg on day 1 fol- lowed by 0.4mg of misoprostol administered vaginally on the third day morning, repeated every 12h (3 times in maxi- mum); Group Ⅱ took 100mg of mifepristone once a day for two days, the administration of misoprostol was the sameas Group Ⅰ; Group Ⅲ took mifepristone 200mg on day 1 followed by 0.4mg of misoprostol administered orally on the third day morning and repeated every 6h (4 times in maximum). Results.. Successful abortion rates in each group were 97.1% in group Ⅰ , 96.0%in group Ⅱ and 92.0% in group Ⅲ , with statistical significance (χ2 =6.05, P=0. 048). Totally 577 women expelled their fetus successfully, and the average induction to abortion interval was 13.43±10.18 h, without statistical significance among groups (F= 1.01 ,P=0. 36). The average amount of misoprostol used were 616.33±317.26 g,634. 99±307. 88 g.797. 85±395. 56 g in the three groups respectively (F=16.20, P=0.00). No statistically significant differences were found for 2h and 24h post-abortion hemorrhage volumes among the three groups. Majority of side effects were gastrointestinal discomforts and most were mild cases with no need for interven- tion. Conclusion; Regimen of group Ⅰ (mifepristone 200mg po. + misoprostol 400μg pv. ) is an optimal for medical a- bortion in pregnancy with 16-24 weeks of gestation.
出处
《中国计划生育学杂志》
2014年第5期329-333,344,共6页
Chinese Journal of Family Planning
基金
上海市人口和计划生育委员会局管科技发展基金项目(2012JG02)
关键词
药物终止妊娠
妊娠中期
米非司酮
米索前列醇
Medical abortion
Second trimester pregnancy
Mifepristone, Misoprostol