中期妊娠胎儿畸形引产术中依沙吖啶注射时机的探讨

Study on the timing of exacridine injection in second trimester fetal malformation induced labor

目的探讨中期妊娠胎儿畸形引产术中依沙吖啶的注射时机。方法回顾性分析湖北省妇幼保健院2017年11月至2021年3月收治的653例中期妊娠胎儿畸形引产孕妇,根据依沙吖啶注射时机的不同分为观察组387例与对照组266例,两组孕妇米非司酮片服用方案相同,观察组自服药起第4天注射利凡诺,对照组自第3天注射利凡诺。比较两组引产成功率、注药后分娩时间、服药后分娩时间、围术期并发症、产后恢复情况、宫颈成熟度(Bishop)评分及疼痛程度。结果两组引产成功率差异无统计学意义(P>0.05);观察组注药后分娩时间较对照组明显缩短(P<0.05);两组服药后分娩时间、产时出血量及围术期并发症发生率比较差异均无统计学意义(P>0.05);观察组注射利凡诺前和注射利凡诺12 h后的宫颈成熟度较对照组高(P<0.05),观察组注射利凡诺12 h后的疼痛程度较对照组轻(P<0.05)。结论中期妊娠胎儿畸形引产术口服米非司酮后延迟利凡诺注射时间,能有效地缩短引产成功时间。

Objective To explore the timing of Ethacridine(Rivanol)application in the induction of labor in the second trimester.Methods The 653 pregnant women who were admitted to the department of gynecology in our hospital from November 2017 to March 2019 were selected as the research objects.According to the timing of the application of Ethacridinel during the operation,they were divided into the observation group(387 cases)and control group(266 cases).Both groups were given oral mifepristone tablets.The observation group were injected with Ethacridine on the 4th day after taking the medicine,while the control group on the 3rd day.The delivery time,perioperative complications,postpartum recovery,cervical maturity(Bishop)score and postoperative pain were compared.Results There was no significant difference in the success rate of labor induction between the two groups(P>0.05);the delivery time in the observation group was significantly shorter than that of the control group after injection(P<0.05).There were no significant differences in delivery time,intrapartum blood loss and perioperative complications between the two groups(P>0.05).The cervical maturity of the observation group before and 12 h after Ethacridine injection was higher than that of the control group(P<0.05);while the pain 12 h after injection was less(P<0.05).Conclusion Delayed Ethacridine injection after oral mifepristone can effectively shorten the successful time of labor induction.