Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland.
Ultrasound Obstet Gynecol. 2009 Oct;34(4):448-53. doi: 10.1002/uog.6418.
The antiprogestin mifepristone is widely used for medical termination of pregnancy (TOP). Previous studies have suggested that the mechanism of mifepristone is based on its action in the endometrium and myometrium. The aim of this study was to evaluate the possible effects of mifepristone on corpus luteum activity.
This was a prospective, longitudinal controlled study to which 20 patients undergoing medical TOP (study group) and 20 patients with normal ongoing pregnancy (control group) were recruited. Medical TOP was induced with 200 mg of mifepristone followed by 0.8 mg of misoprostol 2 days later. Three-dimensional ultrasound examinations and hormone assays (progesterone, human chorionic gonadotropin, and 17-hydroxyprogesterone) were performed in both groups on the day of, and 2 days after, administration of mifepristone. Total volume (vascularized + non-vascularized) of the dominant (containing corpus luteum) and non-dominant ovary and serum hormone levels were measured.
After administration of mifepristone, a decrease in serum progesterone levels was observed with a simultaneous decrease in the non-vascularized volume of the dominant ovary in the study group. No such changes were observed in the control group.
The observations indicate that, in addition to trophoblastic tissue, the corpus luteum is also the target of mifepristone.
抗孕激素米非司酮广泛用于药物终止妊娠（TOP）。先前的研究表明，米非司酮的作用机制基于其在子宫内膜和子宫肌层的作用。本研究旨在评估米非司酮对黄体活性的可能影响。
这是一项前瞻性、纵向对照研究，共招募了 20 例接受药物 TOP（研究组）和 20 例正常持续妊娠（对照组）的患者。研究组给予 200mg 米非司酮，2 天后给予 0.8mg 米索前列醇。两组患者均在给药当天及米非司酮给药后 2 天进行三维超声检查和激素检测（孕酮、人绒毛膜促性腺激素和 17-羟孕酮）。测量优势（含黄体）和非优势卵巢的总体积（血管化+非血管化）和血清激素水平。
米非司酮给药后，研究组血清孕酮水平下降，同时优势卵巢的非血管化体积减少，但对照组未见这种变化。
这些观察结果表明，除滋养层组织外，黄体也是米非司酮的作用靶点。
