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米索前列醇单用与米非司酮联合米索前列醇用于中期妊娠终止的前瞻性对照研究。

Prospective Comparative Study of Misoprostol Alone Versus Mifepristone Plus Misoprostol for Second-Trimester Pregnancy Termination.

作者信息

Saharan Saroj, Rastogi Radha, Sharma Anisha

机构信息

Medical officer, Department of Obstetrics and Gynaecology, CHC, Sangria, Hanumangarh, Rajasthan India.

Senior Professor, Department of Obstetrics and Gynaecology, R.N.T. Medical College, Udaipur, Rajasthan India.

出版信息

J Obstet Gynaecol India. 2024 Dec;74(6):498-504. doi: 10.1007/s13224-024-01953-1. Epub 2024 Mar 6.

Abstract

INTRODUCTION

MTP has been legalized in India through the Medical Termination of Pregnancy Act, of 1971, which allows pregnancy termination up to 20 weeks. The present study included second-trimester pregnancy terminations and the main aim of the study is to compare the efficacy and safety of tablet mifepristone 24 h before vaginal tablet misoprostol in group-I with vaginal tablet misoprostol alone in group-II as a method of second-trimester pregnancy termination.

METHODOLOGY

It was a prospective randomized comparative study conducted at the Department of Obstetrics and Gynaecology, R.N.T. Medical College, Udaipur, Rajasthan, by selecting 100 patients, with equal no, i.e., 50 in each group who attended the inpatient department for second-trimester pregnancy termination (who were fulfilling the criteria as per MTP Act).

RESULTS

From the data analysis of 100 subjects in this study, we observed that the most common indication for second-trimester pregnancy termination was indication (III), which accounts for a total of 60%. Majority of the patients in either group were in the age group between 20 and 30 years, and there was more multigravida as compared to primigravida. The induction termination interval in the Mife-Miso group (group-I) was shorter, i.e., 10.21 h as compared to the Miso group (group-II), i.e.,18 h, and the difference between them was found to be statistically significant (-value 0.004). The complete expulsion rate within 24 h in group-I was 92% as compared to 72% in group-II.

CONCLUSION

The pretreatment with oral mifepristone, provides a more safe, non-invasive, and effective regimen for second-trimester termination of pregnancy, which significantly reduces induction termination interval with more success rate.

摘要

引言

印度通过1971年的《人工流产法》使人工流产合法化,该法案允许在妊娠20周内终止妊娠。本研究纳入了孕中期终止妊娠的案例,其主要目的是比较第一组在阴道给予米索前列醇前24小时口服米非司酮与第二组单纯阴道给予米索前列醇作为孕中期终止妊娠方法的有效性和安全性。

方法

这是一项前瞻性随机对照研究,在拉贾斯坦邦乌代浦尔R.N.T.医学院妇产科进行,选取100例患者,每组50例,这些患者因孕中期终止妊娠入住住院部(符合《人工流产法》规定的标准)。

结果

通过对本研究中100名受试者的数据分析,我们观察到孕中期终止妊娠最常见的指征是指征(III),共占60%。两组中的大多数患者年龄在20至30岁之间,经产妇多于初产妇。米非司酮 - 米索前列醇组(第一组)的引产 - 终止间隔较短,为10.21小时,而米索前列醇组(第二组)为18小时,两者差异具有统计学意义(P值为0.004)。第一组24小时内的完全排出率为92%,而第二组为72%。

结论

口服米非司酮预处理为孕中期终止妊娠提供了一种更安全、无创且有效的方案,可显著缩短引产 - 终止间隔,成功率更高。

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本文引用的文献

3
Pre-induction with Mifepristone for Second Trimester Termination of Pregnancy.米非司酮用于中期妊娠引产的引产预处理。
J Obstet Gynaecol India. 2014 Apr;64(2):102-4. doi: 10.1007/s13224-013-0472-5. Epub 2013 Oct 27.
6
Misoprostol and pregnancy.米索前列醇与妊娠
N Engl J Med. 2001 Jan 4;344(1):38-47. doi: 10.1056/NEJM200101043440107.

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