Ayres-de-Campos D, Teixeira-da-Silva J, Campos I, Patrício B
Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina do Porto, Hospital de S. João, Porto, Portugal.
Int J Gynaecol Obstet. 2000 Oct;71(1):53-7. doi: 10.1016/s0020-7292(00)00257-5.
To evaluate the efficacy of a regimen of vaginal misoprostol in causing the complete expulsion of first-trimester missed abortions, or alternatively dilating the cervix for surgical evacuation.
Seventy-four women with a transvaginal ultrasound diagnosis of a first-trimester missed abortion and no more than slight vaginal bleeding were consecutively enrolled. Misoprostol (600 microg) was administered vaginally and repeated 4 h later if necessary. Surgical evacuation was performed when complete expulsion was not documented on the ultrasound 10-12 h after treatment.
Complete medical evacuation occurred in 42 women (56.8%), 11 (14.9%) of which required only one dose. Seventy women (94.6%) experienced abdominal pain, 73 (98.6%) vaginal bleeding, 10 (13.5%) nausea, 4 (5.4%) vomiting, 5 (6.8%) diarrhea, and 4 (5.4%) transient hyperthermia. There was one case of heavy vaginal bleeding requiring emergency surgical evacuation, and one re-admission for incomplete abortion at 30 days. All but 4 (5.4%) women had permeable cervices at the time of surgery.
The described regimen of vaginal misoprostol is safe and reasonably effective in inducing complete evacuation in missed abortions. When this does not occur, it almost always provides adequate cervical dilatation for surgery.
评估阴道用米索前列醇方案促使孕早期稽留流产完全排出或扩张宫颈以便进行手术清宫的疗效。
连续纳入74例经阴道超声诊断为孕早期稽留流产且仅有少量阴道出血的女性。阴道给予米索前列醇（600微克），必要时4小时后重复给药。治疗后10 - 12小时超声检查未记录到完全排出时，则进行手术清宫。
42例女性（56.8%）药物完全流产成功，其中11例（14.9%）仅需一剂药物。70例（94.6%）出现腹痛，73例（98.6%）出现阴道出血，10例（13.5%）出现恶心，4例（5.4%）出现呕吐，5例（6.8%）出现腹泻，4例（5.4%）出现短暂发热。有1例出现严重阴道出血需紧急手术清宫，1例在30天时因不全流产再次入院。除4例（5.4%）女性外，其余所有女性在手术时宫颈均已软化。
所述阴道用米索前列醇方案在促使稽留流产完全排出方面安全且相当有效。若未出现完全排出，该方案几乎总能为手术提供足够的宫颈扩张。
