米非司酮治疗产后胎盘残留23例

A Clinical Study of the Therapeutic Effect of Mifepristone on Postpartum Placental Remnants

目的 :观察米非司酮治疗严重胎盘残留及胎盘植入的效果。方法 :2 3例胎盘残留患者给予米非司酮 75mg,po ,qd,或分 5 0mg晨空腹服 ,及 2 5mg晚空腹服 ,连服 6d。另同服生化颗粒冲剂 12g,tid。结果 :90 %以上的病例在治疗停止后 1周阴道流血停止 ,其中胎盘植入病例可见有大块坏死胎盘组织排出 ,并经病检证实。全部病例在 2周内阴道流血停止 ,血β hCG正常 ,B超检查宫腔内无组织残留 ,为正常宫腔回声。 1个月后随访 ,全部病例无阴道流血 ,痊愈率10 0 %。结论 :米非司酮治疗严重胎盘残留及胎盘植入具有简便、有效、安全、无痛苦等优点 ,值得临床推广应用。

Objective:To observe the effect of mifepristone on severe postpartum placental remnants and placenta implantation. Methods:Mifepristone was given to each of the 23 parturients belonging to this category either in a single daily dose of 75 mg per os or in 2 divided doses, of which 50 mg were taken in the morning and 25 mg in the evening, respectively, both in fasting condition. The medication lasted 6 days. Concomitantly, the Chinese herbal medicine Shenghuakeli was given to each in a dose of 15g three times a day per os. Results: Vaginal bleeding was stopped in more than 80% of the cases 1 week after the termination of the treatment. Massive necrotic placental debris as shown pathologically were expelled from the vagina of the parturients with placenta implantation. Within 2 weeks after the treatment, there was no vaginal bleeding in all of the cases under observation, the serum β hcG level was normal and no placental remnants in the uterine cavity could be found by B ultrasonic imaging. In a follow up study carried out 1 month later, no vaginal bleeding was seen in any one of the cases observed. The cures rate was 100%. Conclusion:The therapeutic effect of mifepristone on postpartum placental remnants and placenta implantation was good and definite. The treatment is non invasine, easy to carry out, effective,safe and causes no pain. It is thus worth while to spread its clinical application.