Rouzi A A
Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia.
Clin Exp Obstet Gynecol. 2013;40(1):157-8.
Termination of pregnancy in the second trimester for an intrauterine death of a fetus with anencephaly in a woman with previous three cesarean sections is a difficult clinical dilemma. A 34-year-old, gravida 4, para 3 woman was admitted at 20 weeks gestation for termination of pregnancy due to intrauterine death of a fetus with anencephaly. She had had three previous cesarean sections. She received two doses of 200 mcg misoprostol tablets vaginally 12 hours apart. Then two doses of 400 mcg misoprostol tablets were given vaginally 12 hours apart. There were no uterine contractions or cervical changes. Finally, she received five doses of 400 mcg misoprostol tablets vaginally every eight hours. The patient responded after the last dose and the fetus with the placenta aborted completely without complications. The estimated blood loss was 200 ml.
Misoprostol can avoid hysterotomy for termination of pregnancy in the second trimester with history of previous three cesarean sections and an intrauterine death of a fetus with anencephaly.
对于一名曾有三次剖宫产史且胎儿为无脑儿并死于宫内的孕妇，在孕中期终止妊娠是一个棘手的临床难题。一名34岁、孕4产3的妇女，因胎儿无脑儿死于宫内，于妊娠20周入院行终止妊娠术。她曾有过三次剖宫产史。她阴道给予两剂200微克米索前列醇片，间隔12小时。然后又阴道给予两剂400微克米索前列醇片，间隔12小时。未出现子宫收缩或宫颈变化。最后，她每八小时阴道给予五剂400微克米索前列醇片。患者在最后一剂后有反应，胎儿及胎盘完全流产，无并发症。估计失血量为200毫升。
米索前列醇可避免对有三次剖宫产史且胎儿无脑儿死于宫内的孕妇在孕中期行剖宫产来终止妊娠。
