le Roux P A, Pahal G S, Hoffman L, Nooh R, El-Refaey H, Rodeck C H
Department of Obstetrics and Gynaecology, University College Hospital, London, UK.
Eur J Obstet Gynecol Reprod Biol. 2001 Mar;95(1):52-4. doi: 10.1016/s0301-2115(00)00365-1.
To assess the effect of changing the regimen for second trimester induction of labour from gemeprost to mifepristone/misoprostol.
A retrospective study at a university teaching hospital over the 5-year period 1993-1997. SUBJECTS, METHODS and REGIMENS: 68 patients, 34 in the gemeprost group and 34 in the mifepristone/misoprostol group. The gemeprost group received 1mg vaginally every 3h to a maximum of five doses. The mifepristone/misoprostol group were pre-treated with 600 mg mifepristone orally followed by 800 microg misoprostol vaginally and then 400 microg orally every 3h to a maximum of four oral doses.
Induction to abortion interval; delivery within 24h.
The mifepristone/misoprostol group had a lower induction to abortion interval compared to the gemeprost group (median 8.9h versus 19.8h, respectively, p<0.01). The mifepristone/misoprostol regimen was more successful than the gemeprost regimen; 94% versus 68%, respectively, aborted without extra medical or surgical intervention, p=0.02. There were no significant differences in side effects, analgesia requirements or complications between the two groups. Three patients with previous Caesarean sections had a ruptured uterus; two from the gemeprost group and one from the mifepristone/misoprostol group.
The new mifepristone/misoprostol regimen was more effective in second trimester induction of labour. Induction of labour with misoprostol or gemeprost should be used with care in patients with a previous Caesarean section.
评估将孕中期引产方案从吉美前列素改为米非司酮/米索前列醇的效果。
1993年至1997年在一家大学教学医院进行的回顾性研究。对象、方法与方案：68例患者，吉美前列素组34例，米非司酮/米索前列醇组34例。吉美前列素组每3小时阴道给予1mg，最大剂量为5剂。米非司酮/米索前列醇组先口服600mg米非司酮，然后阴道给予800μg米索前列醇，随后每3小时口服400μg，最大口服剂量为4剂。
引产至流产间隔时间；24小时内分娩。
米非司酮/米索前列醇组的引产至流产间隔时间比吉美前列素组短（中位数分别为8.9小时和19.8小时，p<0.01）。米非司酮/米索前列醇方案比吉美前列素方案更成功；分别有94%和68%的患者在无需额外医疗或手术干预的情况下流产，p = 0.02。两组在副作用、镇痛需求或并发症方面无显著差异。3例有剖宫产史的患者发生子宫破裂；吉美前列素组2例，米非司酮/米索前列醇组1例。
新的米非司酮/米索前列醇方案在孕中期引产中更有效。对于有剖宫产史的患者，使用米索前列醇或吉美前列素引产时应谨慎。
