Department of Gynecology and Obstetrics, The Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Contraception. 2011 Sep;84(3):214-23. doi: 10.1016/j.contraception.2011.01.018. Epub 2011 Mar 11.
Mifepristone combined with misoprostol for second-trimester abortion (MM) and intra-amniotic injection of ethacridine lactate (EL; Rivanol®) are the common methods for termination of second-trimester pregnancy in China. The systematic review of relevant literature was conducted to evaluate the effectiveness and safety on termination of second-trimester pregnancy using MM, introduced in 1988 in China, versus the Chinese routinely used method since 1970 -- EL. The review was conducted to evaluate mifepristone combined with the misoprostol versus intra-amniotic injection of ethacridine lactate in China for termination of second-trimester pregnancy with respect to efficacy, side effects, complications and so on.
The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, POPLINE, TOXLINE, World Health Organization-Department of Reproductive Health and Research, Chinese Biomedical Literature Database, Chinese Journal Full-text Database and Chinese Science & Technology Journal Database were systematically searched. Reference lists for English and Chinese-language reports (published from 1966 to 2008) were searched. All randomized controlled trials (RCTs) on second-trimester abortion by combination of mifepristone and misoprostol versus ethacridine lactate, which conducted in China, were analyzed. Trial quality was assessed, and data extraction was made independently by two reviewers.
Fifteen original RCTs using MM versus EL were included. Three trials used oral misoprostol, six trials used vaginal misoprostol, and six trials used oral plus vaginal misoprostol. Failure rate of abortion was 2.0% to 5.9% in the MM group and 7.4% to 20.7% in the EL group. The incidence of postabortion curettage was similar in the two groups. The time of labor and hospitalization for abortion in the MM group were shorter compared with EL group. The blood loss within 2 h of abortion in the MM group was significantly less than that in the EL group, but the blood loss within 24 h of abortion was the same in both groups. More gastrointestinal side effects occurred with the MM regimen, whereas cervical injury occurred more often in the EL group.
Compared with the intra-amniotic injection of ethacridine lactate, mifepristone/misoprostol has a higher success rate and shorter time of labor with more gastrointestinal side effects for termination of second-trimester pregnancy.
米非司酮联合米索前列醇用于中期妊娠引产（MM）和乳酸依沙吖啶宫腔内注射（EL；利凡诺®）是中国常用于终止中期妊娠的两种方法。本系统评价旨在评估中国自 1988 年引进米非司酮联合米索前列醇用于终止妊娠，以及自 1970 年以来常规使用的乳酸依沙吖啶宫腔内注射用于终止妊娠的有效性和安全性。评价米非司酮联合米索前列醇与乳酸依沙吖啶宫腔内注射在中国用于终止中期妊娠的疗效、副作用、并发症等。
系统检索 Cochrane 对照试验中心注册库、EMBASE、MEDLINE、POPLINE、TOXLINE、世界卫生组织生殖健康与研究部、中国生物医学文献数据库、中国期刊全文数据库和中国科技期刊数据库。检索英语和中文报告的参考文献列表（1966 年至 2008 年出版）。对在中国进行的米非司酮联合米索前列醇与乳酸依沙吖啶用于中期妊娠引产的所有随机对照试验（RCT）进行分析。由两位评价员独立评估试验质量并提取资料。
共纳入 15 项 MM 与 EL 比较的原始 RCT。3 项试验采用口服米索前列醇，6 项试验采用阴道米索前列醇，6 项试验采用口服加阴道米索前列醇。MM 组流产失败率为 2.0%至 5.9%，EL 组为 7.4%至 20.7%。两组刮宫率相似。MM 组流产时间和住院时间短于 EL 组。MM 组流产后 2 小时内出血量明显少于 EL 组，但 24 小时出血量两组相同。MM 方案胃肠道副作用较多，EL 组宫颈损伤较多。
与宫腔内注射乳酸依沙吖啶相比，米非司酮/米索前列醇终止中期妊娠的成功率更高，流产时间更短，胃肠道副作用更多。
