米非司酮口服联合依沙吖啶羊膜腔注射对瘢痕子宫中期妊娠的引产效果及安全性评价

Effect and Safety of Mifepristone Combined with Ethacriding Lactate Injection on Labor Induction in Patients with Scar Uterus in the Second Trimester of Pregnancy

目的探讨米非司酮片口服联合乳酸依沙吖啶注射液羊膜腔注射对瘢痕子宫中期妊娠患者的引产效果及安全性。方法选择医院2015年2月至2017年2月收治的瘢痕子宫中期妊娠拟终止妊娠患者98例,随机分为对照组和观察组,各49例。对照组患者在彩色超声引导下于羊膜腔内注射乳酸依沙吖啶注射液100 mg;观察组患者于注射乳酸依沙吖啶注射液前2 d口服米非司酮片,每次50 mg,每隔12 h口服1次,总剂量不超过150 mg,服用完毕后次日注射乳酸依沙吖啶注射液,方法同对照组。如注射给药后48 h宫缩未发动记录为引产失败,可于阴道后穹窿放置米索前列醇片100μg,如仍未出现宫缩可每5 h追加1次,直至分娩发动。结果与对照组比较,观察组完全引产率及引产成功率更高,用药后至规律宫缩及规律宫缩至胎儿完全排出时间更短,引产后24 h阴道出血总量更少,引产并发症发生率更低,差异均有统计学意义(P<0.05);观察组总不良反应发生率虽高于对照组(20.41%比16.33%),但差异无统计学意义(P>0.05)。结论米非司酮片口服联合乳酸依沙吖啶注射液羊膜腔注射对瘢疤痕子宫中期妊娠的引产效果显著,可缩短产程时间,减少引产并发症的发生,且安全性高,值得推广。

Objective To investigate the effect and safety of mifepristone combined with Ethacriding Lactate Injection on labor induction in patients with scar uterus in the second trimester of pregnancy.Methods Totally 98 pregnant women with scar uterus in the second trimester of pregnancy who want to terminate pregnancy admitted to our hospital from February 2015 to February 2017 were randomly divided into the control group and the observation group,49 cases in each group.The patients in the control group were treated with 100mg Ethacridine Lactate Injection under the guidance of color ultrasound.The patients in the observation group were treated with Mesifedone Tablets 2 d before the injection of Ethacridine Lactate Injection,50 mg/time,once every 12 h,the total dose was not more than 150 mg.The next day after taking Mifepristone Tablets,the patients were injected with Ethacridine Lactate Injection,the method was the same as the control group.If uterine contraction was not initiated at 48 h after injection,it could be recorded as a failure of induced labor.Misoprostol 100μg may be placed in the posterior vagina fornix if the no uterine contraction,if there was still no uterine contraction,1 additional time can be added every 5 h until the start of labor.Results The total induction rate and the success rate of induced labor in the observation group were higher than those in the control group(P<0.05).The time from medication to regular uterine contraction,and the time from regular uterine contraction to regular uterine contraction in the observation group were shorter than those in the control group,the total amount of vaginal bleeding at 24 h after induced labor was less than that in the control group,and the incidence rate of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).(P<0.05).The total incidence rate of adverse reactions in the observation group was higher than that in the control group,but the difference was not statistically significant(20.41%vs.16.33%,P>0.05).Conclusion Mifepristone combined with Ethacriding Lactate Injection has significant effect on labor induction in patients with scar uterus in the second trimester of pregnancy,it can shorten the time of production and reduce the incidence of postoperative complications.It is safe and worthy of promotion.