米非司酮与米索前列醇用于黄体期避孕的效果观察

A Clinical Observation on the Efficacy of Mifepristone in Conjunction with Misoprostol for Postcoital Contraception in Luteal Stage

目的 探讨米非司酮与米索前列醇应用于黄体期避孕的临床效果。方法 选择在门诊就诊的身体健康、无甾体避孕药禁忌症,无保护性生活超过120h,或在同一周期中有多次性生活的妇女,自愿要求避孕以避免非意愿妊娠,并保证服药至下次月经不再同房或坚持使用屏障避孕者,有效观察人数68人。在下次预期月经来潮前10d之内,口服米非司酮25mg,早晚两次,连服2d,总量为100mg。48h后口服米索前列醇400μg。月经提前来潮,按时,延迟来潮均为成功,尿HCG(+)、B超证实孕囊大小与月经相符为失败。结果 68例中有4例妊娠,总有效率为94.1％。妊娠率与服药前的性生活次数呈正相关,次数越多怀孕的机率越大。副反应轻微,一般不必处理。月经改变以月经延迟多见。结论 米非司酮与米索前列醇用于黄体期,为那些无保护性生活超过120h或同一周期有多次性生活的妇女,尤其青少年、未产者、不适宜IUD避孕者,提供了一种预防非意愿妊娠安全有效的方法。

Objective To study the effectiveness of mifepristone combined with misoprostol in clinical practice for contraception in luteal phase. Methods Our study included 68 healthy women without contraindications to steroid hormonal contraceptives who volunteered to prevent unwanted pregnancy after 120 hours of unprotected sexual intercourse, and unprotected intercourse after the therapy was prohibited. The therapy consisted of 25mg of mifepristone taken orally twice a day for 2 days within 10 days before next menstrual cycle, and with 400μg of misoprostol taken 48 hours later. Onset of next cycle after medication was considered successful treatment, while urine HCG(+) or detection of gestational sac by ultrasonic examination was regarded as failure. Results 4 were pregnant out of 68 women with the effectiveness of 94.1%. Pregnancy rate was related with the number of intercourse times. The more intercourses, the higher was the pregnancy rate. Side effect of the therapy was slight and no management was needed. Delayed cycle was common when menstrual alternation occurred. Conclusion Administration of mifepristone in conjunction with misoprostol for contraception in luteal stage provides a safe and effective way to prevent unwanted pregnancy for women who have intercourse repeatedly in one cycle or start therapy later than 120 hours after an unprotected intercourse, especially for adolescents, nulliparas, and those who have contraindications to IUD.