Jain J K, Mishell D R
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, USA.
Am J Obstet Gynecol. 1996 Jul;175(1):173-7. doi: 10.1016/s0002-9378(96)70270-3.
Our purpose was to determine whether intracervical placement of laminaria tents would improve the effectiveness of the prostaglandin analog misoprostol for the elective termination of pregnancies in the second trimester.
Sixty-eight women between 12 and 22 weeks of gestation with either an intrauterine fetal death (n = 40) or medical or genetic indications for pregnancy termination (n = 30) were randomized to receive 200 micrograms of misoprostol administered vaginally every 12 hours with or without intracervical placement of laminaria concurrently with the first dose of misoprostol.
The rate of abortion 24 hours after initiation of treatment was 69.7% in the 33 women receiving misoprostol alone and 68.6% in the 35 women treated with misoprostol and laminaria. The abortion rates 48 hours after initiation of treatment were 84.8% and 91.4%, respectively, an insignificant difference. The complete abortion rate was also similar between women receiving misoprostol alone (39.3%) and the group receiving misoprostol and laminaria (37.5%). There were no significant differences in the incidence of fever, vomiting, diarrhea, or pain. The mean interval from initiation of treatment to abortion was also similar, 15.7 hours in those receiving misoprostol alone and 17.4 hours in those treated with misoprostol and laminaria. In both groups women who had live fetuses at the start of the procedure had a higher failure rate of abortion and a longer time interval to abortion than women whose fetus was dead.
Laminaria tents inserted concurrently with the first dose of misoprostol do not significantly improve the abortifacient effect of vaginal misoprostol in the second trimester of pregnancy.
我们的目的是确定宫颈内放置海藻棒是否会提高前列腺素类似物米索前列醇在中期妊娠选择性终止妊娠中的有效性。
68例妊娠12至22周的妇女，其中40例为宫内死胎，30例因医学或遗传原因需要终止妊娠，被随机分为两组，一组每12小时阴道给予200微克米索前列醇，另一组在首次给予米索前列醇时同时宫颈内放置海藻棒。
仅接受米索前列醇治疗的33例妇女中，治疗开始后24小时的流产率为69.7%；接受米索前列醇和海藻棒治疗的35例妇女中，流产率为68.6%。治疗开始后48小时的流产率分别为84.8%和91.4%，差异无统计学意义。单独接受米索前列醇治疗的妇女（39.3%）和接受米索前列醇和海藻棒治疗的组（37.5%）的完全流产率也相似。发热、呕吐、腹泻或疼痛的发生率无显著差异。从治疗开始到流产的平均间隔时间也相似，仅接受米索前列醇治疗的妇女为15.7小时，接受米索前列醇和海藻棒治疗的妇女为17.4小时。两组中，手术开始时胎儿存活的妇女比胎儿死亡的妇女流产失败率更高，流产间隔时间更长。
在首次给予米索前列醇时同时插入海藻棒并不能显著提高米索前列醇在妊娠中期阴道流产的效果。
