药物流产后胎盘残留问题的研究

为减少药物流产后出血,缩短出血时间,将200例孕10～16周药物流产者按不同给药剂量采用不同给药途径终止妊娠,探讨其流产效果及流产后影响胎盘绒毛残留的因素。200例对象中192例流产成功,成功率96％。米索前列醇阴道用药效果明显优于口服(P<0.01)。24小时后清宫者绒毛胎盘残留明显低于即刻清宫(P<0.01)。残留与以往电吸人流次数及米非司酮剂量有关。提示做过二次或二次以上电吸人流手术者,药物流产后宜即刻行清宫术。

An Analysis of the Incomplete Expulsion of Placenta in the Inducing Abortion of 10 - 16 weeks Pregnancy by Mifepristone with Misoprostol.

To explore the effectiveness and the factors concerning the incomplete expulsion of placenta, the data from 200 patients of 10 - 16 weeks pregnancy inducedabortion by mifepristone with misoprostol through different routs and doses were analysed. They were divided into two groups; group Ⅰ administered mifepristone 75 mg once a day for 2 days; group Ⅱ mifepristone 100 mg once a day for 2 days. Then, on day 3, populations in group Ⅰ were divided into 2 subgroups; subgroup 1 with misoprostol 600 mg intravaginally and subgroup 2 with misoprostol 600 mg orally. The protoclo for women in groupⅡ was as the same regimen as that for group Ⅰ. The results showed that the complete abortion rate was singnificantly higher in subgroup 1 than that in subgroup 2. The data related to the residual placenta suggested that the rate of placental residue in the group performed curretages in 24hr after the fetal expulsion was lower than that in the group performed curretages immediately after the fetal expulsion (P<0.05) There were certain correlation between the placental residue and the number of previous suction abortion and the dosage of mifepristone. It is sugqested that patients who have suffered from suction curretage≥2 times previously are better to perform curretage after the expulsion of fetus.