依沙吖啶羊膜腔注射中期引产术的安全性及有效性临床研究回顾性再评价

Effectiveness and safety of ethacridine lactate injected into amniotic cavity for second trimester pregnancy termination-A multicenter retrospective clinical study

目的:评估依沙吖啶羊膜腔注射中期引产的安全性及有效性。方法:回顾性分析全国10家医院依沙吖啶羊膜腔注射中期引产的临床资料。结果:本研究纳入10家医院1893例依沙吖啶羊膜腔注射中期引产妇女,注射与引产间隔中位时间41.5(43.7±14.6)h。3d内成功分娩1798例(95.0%),5d内成功分娩1886例(99.6%)。孕周越大(OR=1.28,P<0.001)、产次越多(OR=1.13,P=0.007)、依沙吖啶使用剂量越大(OR=1.02,P=0.012),规律宫缩发动越早(OR=0.94,P<0.001),则引产间隔时间越短。278例有剖宫产史妇女无子宫破裂发生。结论:依沙吖啶羊膜腔注射中期引产具有较高的安全性及有效性,不增加瘢痕子宫妇女引产风险。

Objective： To evaluate the efficacy and safety of ethacridine lactate injected into amniotic cavity for pregnan cy termination of second trimester. Methods： 1893 pregnant women at 13-28 weeks of gestation from ten hospitals of China during 2011 to 2016, who desired to termination the pregnancy by lactate injected into amniotic cavity, were recruited in this retrospective study. Results： The median abortion interval was 41.5 hours, the average time was 43.7±14.6 hours. Of all patients, 95.0% （n= 1798） had successful, termination within 72 hours and 99.6% （n=1886） within 120 hours. The time interval of abortion was relevant with gestational week （OR = 1.28, P〈0.001）, parity （OR = 1.13,P=0.007）, the dosage of ethacridine lactate （OR=1.02,P〈0.012） and early onset of labor （OR =0.94,P〈0. 001）. Besides, among 278 women with history of prior cesarean delivery, there was no one occurred uterine rupture. Conclusion： Ethacridine lactate may be an effective and safe method applied in pregnancy termination of second trimes ter, and can not increase risk for women with scarred uterine as well.