Cardiovascular complications following medical termination of pregnancy: An updated review

BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing complications.The cardiovascular(CVD)complications occurring post MTP or after stillbirth is not very well described.AIM To help the reader better understand,prepare,and manage these complications by reviewing various cardiac comorbidities seen after MTP.METHODS We performed a literature search in PubMed,Medline,RCA,and google scholar,using the search terms“abortions”or“medical/legal termination of pregnancy”and“cardiac complications”or“cardiovascular complications”.RESULTS The most common complications described in the literature following MTP were infective endocarditis(IE)(n=16),takotsubo cardiomyopathy(TTC)(n=7),arrhythmias(n=5),and sudden coronary artery dissection(SCAD)(n=4).The most common valve involved in IE was the tricuspid valve in 69%(n=10).The most observed causative organism was group B Streptococcus in 81%(n=12).The most common type of TTC was apical type in 57%(n=4).Out of five patients de veloping arrhythmia,bradycardia was the most common and was seen in 60%(3/5)of the patients.All four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary artery.Mortality was only reported following IE in 6.25%.Clinical recovery was reported consistently after optimal medical management following all these complications.CONCLUSION In conclusion,the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing literature.In this review,the most common CVD complication following MTP was noted to be IE and TTC.

Effect of Low Dose of Mifeprostone in Capsules combined with Misoprostol on Termination of Early Pregnancy

ve In this double-blind randomized trial, we compare the effect of 75 mg mifeprostone in capsules on termination of early pregnancy was compared with that of 150 mg in tablets combined with misoprostol.

Effect of Contragestazolin(L14105) on Pregnancy Termination in Rodents

Contragestazolin (L14105) belongs to the class of 2 phenyl triazole isoquinolines. When given subcutaneously, intramuscularly or orally showed potential pregnancy terminating activity in mice, rats, hamsters and guinea pigs, but the dialy doses of oral administration needed were 7.1, 6.3 and 47.6 times (for mouse, rat and hamster) greater than those needed parenterally. L14105 had low affinity to rat uterine progesterone receptor. When cultured human decidual cells were exposed to L14105 0.077～0.155 mmol/L for 24～48 h, the cells' viability markedly dropped and structural changes occurred in comparison with controls. Histological examination of conceptuses of rats showed edema, degeneration, necrosis and atrophy or disappearance of decidual cells nuclei and absorption of embryos after the sc administration of L14105 5 mg/kg for 24～48 h. L14105 stimulated the contractile force of uterine smooth muscle in vivo or in vitro. Conclusion: L14105 shows a very high pregnancy terminating activity. Multiple oral administration is also effective. The mode of action of contragestation is related to damage of decidual cells and stimulation of uterine contractility.

A Simple Procedure for Termination of Pregnancy in the Late First Trimester with Mifeprostone and Misoprostol

Purpose: To assess the efficacy of medical methods for termination of pregnancy at 9 - 12 weeks of gestation. Methods: Between December 2008 and December 2010, the 116 consecutive women received 200 mg oral mifepristone and after 24 - 36 hours they applied 800 μg vaginal misoprostol to medically terminate pregnancy. If the products of conception did not pass, three further doses of 400 μg misoprostol were given vaginally at three hours intervals to medically terminate pregnancy. Results: Of the 116 patients undergoing the procedure 104 (90%) aborted completely. Half of the patients aborted within 6 hours. After medical termination, five per cent of the women were treated because of infection, and five per cent needed a revisit to hospital because of excessive bleeding. Two women received a blood transfusion. Previous live births or previous inducted abortion is presented in the study results. Conclusions: Medical abortion at 9 - 12 weeks’ gestation is a safe alternative to surgery.

Clinical Pharmacodynamics of Mifepristone（RU486） for Termination of Early－Pregnancy

Twenty-four healthy female volunteers with amenorrhea for seven weeks or less.asking for legal termination of pregnancy were recruited and divided into 4 groups (6 each). The subjects were orally administered with RU486 of 50mg (Group Ⅰ). 50mg Q12hx 6 (GrouP Ⅱ),200mg(GrouP Ⅲ)or 600mg(Group Ⅳ).Vacuum aspiration(GrouP Ⅰ)or Methyl Carprost Suppository(PGOS 1.0mg)(GrouP Ⅱ-Ⅳ)was given 72h after the firsl dose followed by a 6--hour medl'cal survel'llance.Blood samples were collected on day 1-6,8,15,43 to measure the serum levels of β-hCG,E2,P,PRL,ACTH, Cortisol,T3,T4 and TSH in each subject.The results showed that no significant dose-effect relationship was observed in terms of clinical efficacy,vaginal bleeding or side effects.All four groups shared the same tendency of changes in serum levels of β-hCG,E2 and P.β-hCG levels increased by 50-100% (P<0.01)24h prior to treatment,and continued ic ipcrease following lreatment until the sac expulsion.EZ levels l'n each group reinal'ned higher than pre-treatment values with the gradual decline in P levels.β-hCG,E2 and P decreased drastically after abortion,levels of β-hCG,E2,P on day 5 were only 35-60% (P<0.01),32-46%(P<0.01)and 30-56%(P<0.01)of those on day 4 respectively.The mean PRL levels on day 2-4 in each group increased obviously but declined gradually following the sac ex.pulsion.During treatment,the respective cortisol levels increased dramatically,the average levels ofcortisol on day 2-4 were 30-40%(P<0.05) l'n GrouP Ⅰ-Ⅲ and 60%(P< 0.01) in Group Ⅳ higher as compared with day 1 values, while decreased rapidly af ter termination of pregnancy as indicated that cortisol levels on day 5 were only 67-81%(P<0.05) of those on day 4.The changes in ACTH,T3,T4,TSH levels were of no statistic sigulAance(P>0.05).This study indicated that RU486 has no dose-effect relationship when used for interruption of early pregnancy and its main action site seems neither in ovary nor in villi.It has some effects on pituitary-adrenal axis,especially in large dosage,however,it has no obvious impact on pituilary-thyroid axis.It seems that the changes in PRL serum levels were directly due to the drug itsed ifs clinical significance should be further studied.

Synthesis and Pregnancy Terminating Activity of 2-Aryl imidazo [2,1-a] isoquinolines

Two 2-aryl imidazo [2,1-a] isoquinolines were synthesized and tested for pregnancy terminating activities. Both of them are new compounds and their structures were confirmed by IR, (HNMR)-H-1, MS and elemental analysis. They both showed high activities in NIH mice.

Prenatal testing and termination of future pregnancies in Arab mothers of children with severe defects: impact of Moslem cleric or physician on the decision making

The authors investigated: 1) How many of 250 Israeli Arab mothers (50% in consanguineous marriages) of babies with severe congenital anomalies had undergone prenatal testing during pregnancy, and how many had refused termination of pregnancy (TOP) when recommended;2) Why TOP had been refused;3) Attitudes regarding prenatal testing and TOP in future pregnancies;and 4) Whether the women would have changed their decision had they been able to talk to a Moslem cleric or Moslem doctor in addition to the regular personnel. Eighty seven (35%) refused to even consider TOP, 55 (22%) agreed to undergo TOP, and 87 (35%) agreed provided the procedure would be performed before 120 days gestation. The remainder were undecided. Of 195 women, the addition of a Moslem religious cleric or physician to the Committee would influence 89 (46%) and 55 (28%), respectively, to change their opinion and agree to TOP, and 26 (13%) and 10 (5%), respectively, to change their opinion and agree to TOP prior to 120 days of gestation. The remainder either continued to refuse TOP or were undecided.

Awareness of the Termination of Pregnancy Act of the Laws of Zambia among Women of Reproductive Age at Kanyama First Level Hospital in Lusaka District Zambia

Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.

Clinical Analyses of 66 Cases of Mid-trimester Pregnancy Termination in Women with Prior Cesarean

Background：The rate of cesarean delivery has significantly increased in China in the last decade.Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in mid-trimester than those without such a history.The aim of our study was to evaluate the influences of the potential risk factors on uterine rupture in women with prior cesarean.Methods：We conducted this retrospective study of women with prior cesarean section,who underwent mid-trimester pregnancy termination between January 2006 and December 2013 in Peking Union Medical College Hospital.The protocol was oral administration ofmifepristone and misoprostol for the patients with the gestational ages below 16 weeks or intra-amniotic injection of ethacridine lactate （EL） for those with at least 16 weeks of gestational ages.The thickness of the lower uterine segment （LUS） was measured before the termination of pregnancy.Logistic regression was used to study the risk factors of uterine rupture.Results：The total rate of successful abortion was 93.9％ （62/66）.Four patients failed in induction,and one of them received curettage,whereas the other three experienced uterine rupture （4.5％）.The successful rates of abortion were 85.7％ （30/35） for women treated with mifepristone-misoprostol and 86.1％ （31/36） for those treated with EL.There was a significant difference in the mean LUS thickness between the uterine rupture group （3.0 ± 2.0 mm） and the nonrupture group （7.0 ± 3.0 mm） （P ＜ 0.05）.The LUS thickness of＜3 mm was associated with uterine rupture during mid-trimester pregnancy termination in women with prior cesarean （odds ratio,94.0; 95％ confidence interval 4.2-2106.1） after adjusted maternal age,gestational age,interdelivery interval and prior cesarean section.Severe bleeding that required transfusion occurred in one case （1.5％）.Conclusions：Both the mifepristone-misoprostol and the EL regimens were effective and safe for the termination of mid-trimester pregnancy in women with prior cesarean.A thinner LUS is associated with a relatively high risk of uterine rupture.

Change of hs-CRP,sVCAM-1,NT-proBNP levels in patients with pregnancy-induced hypertension after therapy with magnesium sulfate and nifudipine

Objective:To investigate the change of the hs-CRP,sVC AM-1,NT-proBNP levels of the patients with pregnancy-induced hypertension(PIH) syndrome.Methods:A total of 200 patients with PIH were divided into mild,moderate and severe group,and 50 healthy pregnancy patients served as the control group.The serum sVCAM-1 levels were detected by enzyme-linked immunosorbent assay,hs-CRP were detected by immunity transmission turbidity,and NT-proBNP levels were determined by the colloidal gold method.Patients were treated with magnesium sulfate and nifudipine and the contrastive analysis was performed before and after treatment.And the pathological changes in placental of PIH patients were delected by hematoxylin-eosin staining at the same time.Results:The hs-CRP,sVCAM-l,NT-proBNP levels of patients in the mild, moderate and severe PHI group were significantly higher than that in the control group(P<0.05). The hs-CKP,sVCAM-l,NT-proBNP levels in the severe group were significantly higher than the mild group and the moderate group,the difference was statistically significant(P<0.05).The hsCRP,sVCAM-l,NT-proBNP of the moderate group were significantly higher than the mild group(P<0.05).There was a positive correlation between hs-CRP,sVCAM-1,NT-proBNP expression levels and the degree of the PIH.The expression of hs-CRP,sVCAM-1,NT-proBNP levels of the moderate and the severe group were significantly decreased(P<0.05).The number of placental villi and interstitial blood vessel in the moderate and severe PIH group were significantly less than the control group(P<0.05).Conclusions:The increased levels of serum hs-CRP,sVCAM-1, NT-proBNP may be involved in the process of vascular endothelial cell injury of the PIH,and the hs-CRP,sVCAM-1,NT-proBNP can be used as the auxiliary index for diagnosis of PIH and determination of PIH severity.

Prenatal congenital heart defects in southern China:detection rate and termination of preqnancy,2006-2016

Objective Congenital heart defect (CHD) is one of the most common birth anomalies with high morbidity and mortality. Previous studies of CHD mostly focus on the postnatal prevalence, mortality and successful rate of operation, etc. This study aimed to explore the detection rate of prenatal CHD and CHD factors that attribute to termination of pregnancy (TOP).

Fetal loss rates after mid-trimester amniocentesis

Objective: Amniocentesis is an invasive cytogenic test traditionally associated with a 1/200 procedure–related pregnancy loss rate. Recent studies have questioned the validity of the traditionally stated rate. The purpose of this study was to document the results of second-trimes- ter genetic amniocentesis performed at our pe- rinatalogy clinic. Study Design: A retrospective review of all the amniocentesis procedures per- formed between 15 and 22 weeks of gestation on singleton pregnancies between May 2004 and December 2008 was performed. Spontaneous loss was defined as any unintentional preg- nancy loss at < 24 weeks of gestation. Setting: Zonguldak Karaelmas University, Faculty of Me- dicine, Department of Obstetrics and Gynecology. Population: Pregnant women followed at the Obstetrics Department. Methods: A retrospective review of all the amniocentesis procedures performed between May 2004 and December 2008 was performed. Main outcome measure: Pregnancy loss due to amniocentesis. Results: A total of 447 amniocentesis procedures were performed during the study period. The major indication for amniocentesis was positive maternal triple screening (44%). The mean gestational age at amniocentesis was 18.80 ± 2.70 weeks. The results of cytogenetic analyses revealed an abnormal karyotype in 19 pregnancies (4.3%), nine of which were trisomy 21. The overall spontaneous loss rate was 0.89% (n = 4). Conclusion: It would be useful for each center to investigate its own pregnancy loss rate and thereby provide a firmer basis for its policy for counseling women requesting amniocentesis. If enough such investigations were reported, a true benchmark figure could also emerge.

Medical Interruption of Pregnancy in the Second Trimester at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF): About 25 Cases

Introduction: Medical termination of pregnancy is a therapy that considerably reduces the number of obstetrical complications that can lead to maternal death and the number of births of children with diseases or malformations that are incompatible with life. Objective: To study the practice of medical termination of pregnancy at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF). Methodology: This was a retrospective and descriptive study conducted at the Principal Clinic of the Togolese Association of Family Well-Being Planning Center (ATBEF) covering the period from May 1st, 2012 to April 30th, 2021, i.e. a period of 9 years. All patients who underwent a medical termination of pregnancy during the study period and whose term of pregnancy was <28 weeks of amenorrhea were included in this study. Information was collected on a survey sheet from the patients’ clinical records, admission and hospitalisation registers, referral forms and operative report registers. Data were entered and analyzed using Excel, World and epi-info 7.2.2. The main variables studied were hospital frequency, diagnostic means, main indications, means of evacuation and maternal prognosis. Result: 25 patients were identified and represented 0.5% of deliveries. Fetal, maternal and obstetric causes were the main indications for medical termination of pregnancy in respectively 28%, 20% and 52%. Obstetrical ultrasound was performed in 100% of patients. These ultrasounds allowed us to determine fetal vitality and to find some fetal malformations (28%) and some anomalies in the fetal appendages (48%). Clinical examination alone was used to diagnose 24% of indications. In 68% of cases, the clinical examination and ultrasound were used to establish the indication. The most commonly used evacuation technique was medication in 88% of cases. Caesarean section was chosen for urgent cases in 12%. Uterine haemorrhage and post-abortion endometritis were the main complications. Conclusion: Medical termination of pregnancy is a delicate subject requiring multidisciplinary management. This series has allowed us to highlight our singularities, and will allow us to improve the management of our patients, in the prevention of haemorrhage and other complications.

Evaluation on the Influence of the Timing of Twin Pregnancy Termi­nation on the Outcome of Mother and Infants

Objective:Objective:To observe the maternal and infant outcomes of pregnant women with twins terminating their pregnancy at different timings.Methods:Among the twin pregnant women admitted to our hospital from August 2019 to August 2020,50 primiparous women who opted to terminate their pregnancies at 5 different timings of“34--34^(+6) weeks”,“35--35^(+6) weeks”,“36--36^(+6) weeks”,“37--37^(+6) weeks”,“38--38^(+6) weeks”were selected as the research subjects.According to the timing of pregnancy termination,they were divided into 5 groups,each with 10 cases of pregnant women,and the impact of the timing of pregnancy termination on the outcome of the mothers and infants were compared.Results:The“37--37^(+6) weeks”group had the largest amount of postpartum hemorrhage,and the difference in Hb level before and after delivery was the largest.With the increase in gestational week,the weight of both large and small fetuses increased.In terms of neonatal diseases,the comparison between“34--34^(+6) weeks”,“35--35^(+6) weeks”,“36--36^(+6) weeks”and“37--37^(+6) weeks”,“38--38^(+6) weeks”,P<0.05,the comparison between“37--37^(+6) weeks”and“38--38^(+6) weeks”,P>0.05.Conclusions:The extension of the gestational week of twin pregnancies has no effect on postpartum hemorrhage,but it can improve the outcome of infants.

意外妊娠终止女性创伤后心理应激反应状况

目的:了解意外妊娠终止女性创伤后心理应激反应现状及相关因素。方法:选取福建省2所三级甲等医院的意外妊娠终止女性388例,采用事件影响量表修订版(IES-R)、医院焦虑抑郁量表(HADS)、心理弹性量表(CD-RISC)、围产期悲伤量表(PGS)进行调查。IES-R总分≥35分为创伤后应激障碍筛查阳性。结果:IES-R总分为(20.6±12.4)分,创伤后应激障碍筛查阳性率16.5%。多元线性回归分析结果显示,认为怀孕时机合适者IES-R总分高于认为怀孕时机错误者(β=0.13)、终止妊娠过程中中度疼痛者IES-R总分低于重度疼痛者(β=-0.09);IES-R总分与孕周、HADS孕期抑郁得分和PGS现存悲伤得分正向关联(β=0.18、0.27、0.16),与CD-RISC乐观得分负向关联(β=-0.12)。结论:意外妊娠终止女性的创伤后心理应激反应处于中等水平,认为怀孕时机合适、终止妊娠过程中重度疼痛、孕周大、孕期抑郁水平高、终止妊娠后现存悲伤水平高者易发生创伤后心理应激反应。

完全足月妊娠可疑羊水过少不同处理方法的临床研究

目的 回顾性探究完全足月(39~40+6周)妊娠可疑羊水过少不同治疗方法的有效性和安全性。方法 选取2019年1月至2020年12月在首都医科大学附属北京同仁医院产科住院的孕39~40+6周、无阴道分娩禁忌症、有阴道试产意愿、可疑羊水过少的孕妇160例作为研究对象,按照治疗方法将孕妇分为期待治疗组78例和终止妊娠组82例。期待治疗组孕妇年龄(30.0±2.9)岁,分娩孕周(40.0±1.2)周。终止妊娠组孕妇年龄(30.8±2.7)岁,分娩孕周(39.1±1.2)周。比较不同处理方式的两组妊娠结局及新生儿情况。结果 期待治疗组的分娩孕周大于终止妊娠组(P<0.05),但两组的剖宫产率差异无显著性。期待治疗组胎儿窘迫率、羊水胎粪污染率、绒毛膜羊膜炎发生率均高于终止妊娠组(P<0.05),新生儿转入儿科率高于终止妊娠组(P<0.05)。本研究中新生儿窒息发生率为3.1%。新生儿体重、新生儿窒息、新生儿脐动脉PH<7、新生儿1 minApgar评分<7分组间差异无显著性。结论 若发现可疑羊水过少且孕周大于39周、无阴道分娩禁忌症,可考虑促宫颈成熟后积极引产。

心理弹性在孕中期终止妊娠产妇创伤后成长与应对方式间的中介效应研究

目的 探讨心理弹性在孕中期终止妊娠产妇创伤后成长与应对方式间的中介作用。方法 采用便利抽样法选择2020年2月至2023年7月南京医科大学第一附属医院产科接收的368例孕中期终止妊娠产妇作为研究对象。评估产妇创伤后成长、心理弹性及应对方式,分析三者间关系,并进行中介效应检验。结果 孕中期终止妊娠产妇创伤后成长评定量表评分与成人心理弹性量表评分、简易应对方式量表积极维度评分呈正相关(r>0,P<0.05),与简易应对方式量表消极维度评分呈负相关(r<0,P<0.05);成人心理弹性量表评分与简易应对方式量表积极维度评分呈正相关(r>0,P<0.05),与简易应对方式量表消极维度评分呈负相关(r<0,P<0.05)。心理弹性在创伤后成长与积极应对方式及消极应对方式间均起到部分中介作用,中介效应量分别为53.26%和81.03%。结论 孕中期终止妊娠产妇创伤后成长与心理弹性、应对方式关联紧密,临床应对心理弹性予以重视,通过改善产妇心理弹性,提高创伤后成长水平。

脐血管栓塞病因和诊治方案的研究进展

脐血管栓塞属于一种罕见的脐带血管异常,一旦发生将导致一系列严重围产期并发症。所以通过产前寻找高危因素、及时发现脐血管数目的变化,可以有效规避不良的妊娠结局。通过对国内外相关病例报道及最新研究进行综述,为临床上诊断和鉴别并且干预脐血管栓塞提供有效的参考依据,以明确诊疗方案,尽早进行干预,必要时终止妊娠,提高围产儿的有效生存率及改善新生儿的预后。

妊娠中期需终止妊娠PA患者应用UAE术联合依沙吖啶羊膜腔注药治疗的回顾性研究

目的将子宫动脉栓塞(UAE)术与依沙吖啶羊膜腔注药联合用于妊娠中期需终止妊娠的胎盘植入(PA)患者中,观察其应用效果,为PA患者治疗方案的合理选择提供参考。方法本研究为回顾性分析,收集2020年1月~2021年8月于濮阳市妇幼保健院终止妊娠的95例妊娠中期PA患者临床资料,根据引产方式不同分为对照组(47例,依沙吖啶羊膜腔注药引产)及观察组(48例,UAE术联合依沙吖啶羊膜腔注药引产),比较两组临床疗效、引产前后血清血管内皮生长因子(VEGF)、可溶性酪氨酸激酶受体-1(SFlt-1)、性激素水平,记录两组并发症情况。结果与对照组相比,观察组阴道流血量较少,胎盘组织排出、β-人绒毛膜促性腺激素(HCG)转阴、B超血流消失、住院及月经复常时间较短(P<0.05);两组引产后1d的血清VEGF、SFlt-1、孕酮(P)、泌乳素(PRL)、雌二醇(E2)水平均降低,且观察组更低(P<0.05);与对照组相比,观察组大出血、子宫切除发生率较低(P<0.05)。结论妊娠中期PA患者联合应用依沙吖啶羊膜腔注药与UAE术引产安全有效,能使患者出血量明显减少,并能改善VEGF、SFlt-1、性激素水平,促进身体恢复。

米非司酮不同给药方案对终止妊娠后阴道出血时间、子宫内膜容受性的影响

目的:探究米非司酮不同给药方案对终止妊娠后阴道出血时间、子宫内膜容受性的影响。方法:回顾性分析2021年5月-2023年5月本院收治的96例药物终止妊娠临床资料,依据米非司酮使用情况分为单次组(n=30)、常规组(n=34)、长期组(n=32),分别予以米非司酮100mg顿服、150mg分2d口服、150mg分2.5d口服。比较3组术后阴道出血情况,后术3个月子宫内膜容受性指标子宫内膜厚度、阻力指数(RI)、搏动指数(PI)、卵巢功能指标雌二醇(E2)、孕酮(P)、抗苗勒氏管激素(AMH)差异,术后并发症、用药不良反应。结果:单次组术中阴道出血量(23.2±3.6 ml)、阴道出血时间(4.1±0.9d)、术后阴道出血量(57.7±8.4 ml)、月经复潮时间(25.7±2.4d)均低于常规组(27.0±4.1d、4.7±1.1 ml、62.5±9.6d、28.5±2.7 ml)、长期组(27.6±4.1 ml、5.1±1.1d、65.3±10.0 ml、29.6±3.0d)(均P<0.05),常规组与长期组上述指标均无差异(P>0.05);终止妊娠3个月后,单次组子宫内膜厚度(8.35±0.76mm)高于常规组(7.84±0.81mm)、长期组(7.69±0.88mm),RI低于长期组,PI均低于常规组、长期组(均P<0.05);3组E2、AMH、P水平及术后并发症均无差异(P>0.05);恶心呕吐、胃痛发生率单次组(3.3%、10.0%)、常规组(2.9%、8.8%)均低于长期组(21.9%、34.4%)(均P<0.05),3组腹泻、头晕、乏力发生率未见差异(P>0.05)。结论:单次大剂量米非司酮有助于终止妊娠,延长用药时间可能导致用药不良反应增多。