预防性子宫动脉栓塞术联合米非司酮、依沙吖啶在中期妊娠完全性胎盘前置引产中的应用

Application of Preventive Uterine Artery Embolization Combined with Mifepristone and Ethacridine in the Induced Labor of Complete Placenta Previa in the Second Trimester

目的探讨预防性子宫动脉栓塞术(UAE)联合米非司酮、依沙吖啶在中期妊娠完全性胎盘前置(CPP)引产中的应用效果。方法对2019年1月至2021年1月永城市人民医院收治的98例中期妊娠CPP孕妇进行回顾性分析,按引产方案将其分成常规药物组(49例)和联合组(49例)。常规药物组接受米非司酮联合依沙吖啶引产,联合组接受预防性UAE联合米非司酮、依沙吖啶引产。对比两组引产情况[引产总失血量、引产时间、输注红细胞量、引产前后血红蛋白(Hb)水平]、引产成功率以及并发症发生率。结果两组引产前后Hb水平对比,差异无统计学意义(P>0.05);两组输注红细胞量比较,差异无统计学意义(P>0.05);联合组引产时间较常规药物组长,引产总失血量较常规药物组少(P<0.05)。联合组引产成功率较常规药物组高(P<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论将预防性UAE联合米非司酮、依沙吖啶应用于中期妊娠CPP引产中可有效提高引产成功率,减少引产总失血量,且未增加并发症发生风险,但引产时间相对较长。

Objective To explore the application effect of preventive uterine artery embolization(UAE)combined with mifepristone(MIF)and ethacridine(EL)in the induced labor of complete placenta previa(CPP)in the second trimester.Methods A total of 98 pregnant women with CPP in the second trimester treated in Yongcheng People’s Hospital from January 2019 to January 2021 were analyzed retrospectively.They were divided into routine drug group(49 cases)and combined group(49 cases)according to the induced labor scheme.Routine drug group received MIF combined with EL for labor induction,and combined group received preventive UAE combined with MIF and EL for labor induction.The induced labor situation,including total blood loss during induction,time of induction,amount of red blood cell transfusion,hemoglobin(Hb)levels before and after induction,success rate of labor induction and incidence of complications were compared between the two groups.Results There were no statistical differences in Hb levels before and after induction between the two groups(P>0.05).There was no statistical difference in amount of red blood cell transfusion between the two groups(P>0.05).The induction time of combined group was longer than that of routine drug group,and the total blood loss during induction of combined group was less than that of routine drug group(P<0.05).The success rate of labor induction of combined group was higher than that of routine drug group(P<0.05).There was no statistical difference in the incidence of complications between the two groups(P>0.05).Conclusion Preventive UAE combined with MIF and EL in the induced labor of CPP in the second trimester can effectively increase the success rate of labor induction,reduce the total blood loss,and does not increase the risk of complications,but the induction time is relatively long.