Otto-von-Guericke-Universitat Magdeburg, Leibnizstrasse 43, 39104, Magdeburg, Germany.
, Braunschweig, Deutschland.
Arch Gynecol Obstet. 2024 Oct;310(4):2115-2121. doi: 10.1007/s00404-024-07628-6. Epub 2024 Aug 13.
The treatment of early miscarriage with medication is effective and low in side effects. Nevertheless, no uniform dosage regimen has yet been established, nor has it been possible to determine whether previous pregnancies and births with their respective modes of delivery play a role in the effectiveness of Misoprostol. This study aimed to find predictive parameters for successful treatment with Misoprostol in early miscarriage.
In a retrospective study at the Otto von Guericke University Women's Hospital, records of patients with early miscarriage and medical treatment using Misoprostol from 2018 to 2021 were reviewed for this purpose. The need for a curettage subsequent to treatment was scored as a parameter of failure. The data were analyzed using Statistical Package for the Social Science Version 28.0. The significance level was set to 0.050.
We found that successful therapy with misoprostol was seen in 86% (n = 114). 14% (n = 20) of the patients had curettage after taking Misoprostol as advised. Out of 134 women, 16% (n = 21) reported mild side effects, with nausea as the leading one (9.2% (n = 12)). Significance was found comparing the measurement of double endometrial stripe thickness after the second cycle of Misoprostol in women with and without curettage after medical treatment (exact value two-sided 0.035 at p < 0.05). A cutoff value at 8.8 mm was calculated using ROC Analysis.
Our results indicate that the treatment of early miscarriage in the first trimester with Misoprostol is effective and has few side effects. The measurement of the endometrial stripe thickness after the second cycle of Misoprostol via transvaginal ultrasound could present a predictive marker during therapy.
药物治疗早期流产有效且副作用低。然而，尚未建立统一的剂量方案，也无法确定既往妊娠和分娩及其各自的分娩方式是否对米索前列醇的疗效有影响。本研究旨在寻找米索前列醇治疗早期流产成功的预测参数。
在回顾性研究中，对 2018 年至 2021 年在奥托·冯·格里克大学妇女医院因早期流产接受米索前列醇药物治疗的患者的记录进行了回顾。将治疗后需要刮宫作为治疗失败的参数进行评分。使用统计软件包 28.0 对数据进行分析。显著性水平设定为 0.050。
我们发现米索前列醇治疗成功率为 86%（n=114）。14%（n=20）的患者按照建议服用米索前列醇后需要刮宫。在 134 名女性中，16%（n=21）报告有轻微副作用，以恶心为主（9.2%（n=12））。在接受米索前列醇治疗后是否需要刮宫的两组女性中，第二次米索前列醇周期后双子宫内膜条纹厚度的测量值存在统计学意义（确切值双侧 0.035，p<0.05）。使用 ROC 分析计算出 8.8mm 的截断值。
我们的结果表明，米索前列醇治疗早期流产在第一个三个月有效且副作用少。经阴道超声测量第二次米索前列醇周期后的子宫内膜条纹厚度可能是治疗过程中的一个预测指标。
