影响早孕药物流产失败的相关因素分析

Analysis of the Related Factors Influencing the Failure of Drug Abortion in Early Pregnancy

目的探讨导致早孕女性药物流产失败的相关因素。方法本组课题以我院门诊收治于2016年8月至2018年8月的782例早孕患者作为实验对象,入选患者均使用米非司酮、米索前列醇进行药物流产,结合其临床相关资料,对药物流产失败的影响因素进行分析。结果 782例早孕患者中,有70例(8.95%)患者流产失败。经药物流产失败率统计,年龄<35岁者占比6.5%,孕龄≤42d者占比6.6%,孕囊直径<20mm者占比4.3%,子宫位置属前倾/水平位者占比4.8%,单次孕产者占比7.3%,经期<5d者占比6.8%,既往无剖宫产史者占比6.7%,上述数据与年龄≥35岁、孕龄>42d、孕囊直径≥20mm、子宫位置属后倾/后屈位、多次孕产、经期≥5d以及既往有剖宫产史者对比,差异显著,有统计学意义(P<0.05)。结论导致早孕女性药物流产失败的原因较复杂,涉及年龄、孕龄、孕囊直径以及既往有无剖宫产等多种因素,临床应综合评估、加强观察,以提升药物流产的成功率。

Objective To explore the related factors leading to the failure of medical abortion in women with earlypregnancy. Methods A total of 782 early-pregnancy patients admitted to our hospital from August 2016 to August 2018 were enrolled in the study. All patients were treated with mifepristone and misoprostol for medical abortion. Data,analysis of the factors affecting the failure of medical abortion. Results Of the 782 early-pregnancy patients, 70(8.95%)had a miscarriage failure. According to the statistics of the failure rate of medical abortion, the proportion of thoseaged <35 years old was 6.5%, the proportion of gestational age ≤42 d was 6.6%, the proportion of gestational sac <20 mmwas 4.3%, and the position of uterus was anteversion/level 4.8%, the proportion of single pregnant women was 7.3%,the proportion of menstrual period <5 d accounted for 6.8%, and the proportion of previous history without cesareansection was 6.7%. The above data and age ≥35 years old, gestational age>42 d, gestational sac diameter ≥20 mm, uterineposition was retrograde/posterior flexion, multiple pregnancy, menstrual period ≥5 d and previous cesarean sectionhistory, the difference was significant, statistically significant(P<0.05). Conclusion The causes of medical abortion inwomen with early pregnancy are more complicated. They involve age, gestational age, gestational sac diameter andprevious cesarean section. The clinical evaluation should be comprehensive and enhanced observation to improve thesuccess rate of medical abortion.