米索前列醇用于有五次剖宫产史女性的流产管理：一例病例报告及文献综述
Misoprostol for miscarriage management in a woman with previous five cesarean deliveries: a case report and literature review.
作者信息
AlSaad Doua, Alobaidly Sawsan, Abdulrouf Palli, Thomas Binny, Ahmed Afif, AlHail Moza
机构信息
Department of Pharmacy, Women's Hospital, Hamad Medical Corporation, Doha, Qatar.
Public Health Program, London School of Hygiene and Tropical Medicine, University of London, UK.
出版信息
Ther Clin Risk Manag. 2017 May 9;13:625-627. doi: 10.2147/TCRM.S132294. eCollection 2017.
BACKGROUND
Misoprostol is an effective medical method for the management of pregnancy loss. However, data on its efficacy and safety in women with previous cesarean deliveries are limited.
CASE PRESENTATION
We report a 36-year-old patient, gravida 11 para 6, with a diagnosis of missed miscarriage at 15 weeks of gestation. The patient had a significant obstetric history of previous five cesarean deliveries and uterine rupture. Following patient counseling about the medical and surgical options of managing her miscarriage, the patient opted for medical method. Low-dose misoprostol of 100 µg was inserted vaginally and repeated again after 6 hours. The patient had an uneventful complete miscarriage following the second dose of misoprostol. No uterine rupture, no extra vaginal bleeding, and no blood transfusion were observed.
CONCLUSION
We conclude that adopting a low-dose misoprostol protocol could be potentially safe and effective in managing second trimester missed miscarriage in women with repeated cesarean deliveries and/or uterine rupture history. Further studies are needed to confirm these results.
背景
米索前列醇是处理流产的一种有效医学方法。然而，关于其在有剖宫产史女性中的疗效和安全性的数据有限。
病例报告
我们报告一名36岁患者，孕11产6，妊娠15周时诊断为稽留流产。该患者有既往五次剖宫产及子宫破裂的显著产科病史。在向患者咨询处理其流产的药物和手术选择后，患者选择了药物方法。将100μg低剂量米索前列醇经阴道置入，6小时后重复一次。第二次给予米索前列醇后，患者顺利完全流产。未观察到子宫破裂、阴道外出血及输血情况。
结论
我们得出结论，采用低剂量米索前列醇方案在处理有重复剖宫产和/或子宫破裂病史的女性中期妊娠稽留流产时可能是安全有效的。需要进一步研究来证实这些结果。
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