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米非司酮与舌下含服米索前列醇用于早期药物流产

Use of mifepristone and sublingual misoprostol for early medical abortion.

作者信息

Lin Mau, Li Yiu-Tai, Chen Fu-Min, Wu Shu-Fang, Tsai Ching-Wan, Chen Tien-Hui, Kuo Tsung-Cheng

机构信息

Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2006 Dec;45(4):321-4. doi: 10.1016/S1028-4559(09)60251-5.

Abstract

OBJECTIVE

Existing drug-induced abortion techniques involve oral administration of 200 mg of mifepristone, followed by oral administration of 600 microg of misoprostol 48 hours later, but the effects are variable. As revealed by recent research, sublingual and oral administrations of misoprostol are equally efficacious in terms of rapid absorption, but the former lasts longer in serum. Hence, in the near future, sublingual administration of misoprostol may become the most effective way to induce abortion.

MATERIALS AND METHODS

Women with intrauterine pregnancy up to 49 gestational days received vaginal ultrasonography, followed by oral administration of mifepristone 200 mg and sublingual administration of misoprostol 600 microg 48 hours later. They returned for follow-up consultations 3 and 14 days after. The definition of a successfully induced complete medical abortion was that the abortion occurred without surgery or evacuating the uterus.

RESULTS

A total of 356 women underwent medical abortion; the complete abortion rate was 98.3% (350 women). Medical abortion was unsuccessful in five (1.7%) women, who eventually had to undergo dilation and curettage. Patients found the side effects to be bearable; the reported satisfaction rate was 89.9% (325 women).

CONCLUSION

Medical abortion for early termination of pregnancy should be achieved by oral administration of mifepristone, followed by sublingual administration of misoprostol.

摘要

目的

现有的药物流产技术是口服200毫克米非司酮,48小时后口服600微克米索前列醇,但效果不一。近期研究表明,米索前列醇舌下含服和口服在快速吸收方面同样有效,但前者在血清中的持续时间更长。因此,在不久的将来,米索前列醇舌下含服可能会成为最有效的流产诱导方式。

材料与方法

妊娠49天内的宫内妊娠女性接受阴道超声检查,随后口服200毫克米非司酮,48小时后舌下含服600微克米索前列醇。她们在3天和14天后返回进行随访咨询。成功诱导完全药物流产的定义是无需手术或清宫即可流产。

结果

共有356名女性接受了药物流产;完全流产率为98.3%(350名女性)。5名(1.7%)女性药物流产失败,最终不得不接受刮宫术。患者发现副作用可以忍受;报告的满意率为89.9%(325名女性)。

结论

早期终止妊娠的药物流产应通过口服米非司酮,随后舌下含服米索前列醇来实现。

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