[未生育女性选择性流产前宫颈准备中硫前列酮与米索前列醇的随机对照研究]

[Randomized study of sulprostone versus misoprostol in the cervical preparation before elective abortion in nulliparous women].

作者信息

Schaub B, Fuhrer P, Sainte-Rose D

机构信息

Service de Gynécologie-Obstétrique 2, Hôpital Victor-Fouche, CHU de Fort-de-France, Martinique.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1995;24(5):505-10.

PMID:7499737

Abstract

OBJECTIVE

To assess the effectiveness and side effects of misoprostol versus suprostone in cervix preparation before aspiration abortion in the nullipara.

METHODS

Ninety nulliparous women requesting medical abortion with gestations varying from 7 to 12 weeks were included in a prospective randomized study after informed consent. Women with contraindications for prostaglandins and those consulting before 7 weeks gestation were excluded from the study. The women were assigned to 30 groups randomly: women in group A were given 500 micrograms sulprostone in 250 saline solution infused at a rate of 100 micrograms/h 12 hours before the abortion; women in groupe B were given 400 micrograms misoprostol per os 3 hours before abortion; and women in groupe C were given 400 micrograms misoprostol per os 12 hours before abortion.

RESULTS

The three groups were not different for age, parity or gestation, gestational age at abortion or type of anaesthesia. Dilatation of the cervix after treatment was identical in groups A and C (8.60 +/- 1.3 vs 8.20 +/- 1.3; NS) but was greater in group A than in group B (8.60 +/- 1.3 vs 7.23 +/- 2.2; p = 0.02). Maximal dilatation was the same in the three groups (9.50 +/- 0.8, 9.10 +/- 1.3, 9.17 +/- 0.8 respectively). Rate of partial expulsion was higher in groups A and C (23 and 6%) compared with group B (0%). Tolerance was much better with misprosol than with sulprostone: 43% digestive disorders in group A versus 15% in groupe B and C (p = 0.003); 80% pelvic pain with sulprostone versus 53% with misoprostol (p = 0.01); 70% metrorrhagie with sulprostone versus 38% with misoprostol (p = 0.04) and 36% with more bleeding than cycles in the sulprostone subjects versus 12% in the misoprostol subjects (p = 0.005).

CONCLUSION

Misoprostol at a dose of 400 micrograms per os 12 hours before abortion in the nullipara is an interesting alternative to sulprostone. It is equally effective for cervix dilatation, tolerance is much better and cost is lower.

摘要

目的

评估米索前列醇与磺前列酮在未产妇人工流产术前宫颈准备中的有效性及副作用。

方法

90例要求药物流产且妊娠7至12周的未产妇在签署知情同意书后纳入一项前瞻性随机研究。排除有前列腺素禁忌证的妇女以及妊娠7周前前来咨询的妇女。将这些妇女随机分为3组：A组妇女在流产前12小时以100微克/小时的速度静脉滴注含500微克磺前列酮的250毫升生理盐水；B组妇女在流产前3小时口服400微克米索前列醇；C组妇女在流产前12小时口服400微克米索前列醇。

结果

三组在年龄、产次、妊娠情况、流产时的孕周或麻醉方式方面无差异。治疗后A组和C组宫颈扩张情况相同（8.60±1.3 vs 8.20±1.3；无显著性差异），但A组宫颈扩张程度大于B组（8.60±1.3 vs 7.23±2.2；p = 0.02）。三组最大宫颈扩张程度相同（分别为9.50±0.8、9.10±1.3、9.17±0.8）。A组和C组的部分排出率高于B组（分别为23%和6% vs 0%）。米索前列醇的耐受性远优于磺前列酮：A组43%出现消化系统紊乱，而B组和C组为15%（p = 0.003）；磺前列酮组80%出现盆腔疼痛，米索前列醇组为53%（p = 0.01）；磺前列酮组70%出现子宫出血，米索前列醇组为38%（p = 0.04），且磺前列酮组36%出血量多于月经量，米索前列醇组为12%（p = 0.005）。