Carbonell J L, Valera L, Velazco A, Tanda R, Sánchez C
Hospital Docente Gineco-Obstétrico Eusebio Hernández (Maternidad Obrera), Ciudad de la Habana, Cuba.
Eur J Contracept Reprod Health Care. 1998 Jun;3(2):93-8. doi: 10.3109/13625189809051410.
To demonstrate the effectiveness and safety of misoprostol without the need of postexpulsion systematic curettage in early second-trimester abortions, i.e. at 13-15 weeks' gestation.
A group of 151 women, with gestations from 85 to 105 days, received 800 micrograms of vaginal misoprostol every 25 h for a maximum of three doses, without having postexpulsion systematic preventive curettage performed. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side-effects, mean expulsion time and mean time of vaginal bleeding.
Complete abortion occurred in 121/151 subjects (80%; 95% confidence interval, 78-87%). The decrease in hemoglobin was statistically significant (p = 0.0001), but without clinical relevance (11.8 mg/dl (SD, 0.9) before treatment and 11.4 mg/dl (SD, 1.0) afterwards. No statistically significant differences were found between the success rate and any of the women's characteristics. Vaginal bleeding lasted 6 +/- 3 days, spotting 6 +/- 3 days, and total bleeding 12 +/- 5 days (median, 11 days; range, 1-29).
The acceptable expulsion time in 80% of the cases, the fact that postabortion systematic curettage was not needed, the clinically insignificant hemoglobin loss and the abortion rate obtained, show that misoprostol by vaginal administration may be an alternative for interrupting gestation in the early second trimester of pregnancy.
证明米索前列醇在孕中期早期（即妊娠13 - 15周）流产时无需清宫术后系统性刮宫的有效性和安全性。
一组151名妊娠85至105天的妇女，每25小时阴道给予800微克米索前列醇，最多三剂，不进行清宫术后系统性预防性刮宫。观察指标包括流产成功（无需手术的完全流产）、副作用、平均排出时间和平均阴道出血时间。
121/151名受试者发生完全流产（80%；95%置信区间，78 - 87%）。血红蛋白下降具有统计学意义（p = 0.0001），但无临床相关性（治疗前为11.8 mg/dl（标准差，0.9），治疗后为11.4 mg/dl（标准差，1.0））。成功率与任何女性特征之间均未发现统计学显著差异。阴道出血持续6±3天，点滴出血6±3天，总出血时间12±5天（中位数，11天；范围，1 - 29天）。
80%病例中可接受的排出时间、无需流产后系统性刮宫、血红蛋白损失无临床意义以及所获得的流产率表明，阴道给药米索前列醇可能是妊娠中期早期终止妊娠的一种替代方法。
