异丙酚无痛人工流产术前应用卡孕栓或米索前列醇的临床观察

目的：探讨异丙酚无痛人工流产术前应用卡孕栓及米索前列醇的临床效果。方法：采用人工流产术前2h阴道给药卡孕栓0.5mg及口服米索前列醇400μg。结果：用药后宫颈松弛，子宫收缩，解决了人工流产术中宫颈扩张困难问题，降低了异丙酚麻醉下手术的风险，效果显著，结论：阴道给药卡孕栓0.5mg或口服米索前列醇400μg是异丙酚无痛人工流产术前很好的辅助方法，值得推广。     

米非司酮配伍米索前列醇及卡孕栓终止早孕的临床比较

米非司酮配伍米索前列醇或卡孕栓终止早孕的药物流产已被公认为是一种非手术终止妊娠的方法．已经被广大孕妇及医生接受。作者将本院2004年1—12月门诊应用米非司酮配伍米索前列醇与米非司酮配伍卡孕栓终止早孕的疗效进行对比，旨在了解2组药物抗早孕的效果。     

米非司酮配伍米索前列醇及卡孕栓治疗稽留流产临床观察

目的探讨米非司酮配伍米索前列醇及卡孕栓治疗稽留流产的临床疗效及安全性。方法将200例确诊为稽留流产的患者随机分为A组100例,应用米非司酮配伍米索前列醇及卡孕栓;B组100例,应用乙烯雌酚。结果A组用药后完全流产率为73％,不全流产率为27％,清官率为27％;B组用药期间无一例流产,均行钳刮术。两组流产过程中,出血量比较有显著性差异（P〈0．01）。手术中宫颈松弛情况、手术时间、再次清宫率及清官术人流综合征发生情况比较均有显著性差异（P〈0．05）。结论米非司酮配伍米索前列醇及卡孕栓治疗稽留流产完全流产率高,出血少,清官容易,清官率低,无需再次清宫,清宫术中人流综合征发生率低,而且痛苦小,患者容易接受,是安全、有效、可靠的方法,值得临床推广。     

卡前列甲酯栓与米索前列醇终止早孕的临床比较

目的比较小剂量卡前列甲酯栓(卡孕栓,PG05)配伍米非司酮与米索前列醇(米索)配伍米非司酮终止早孕的疗效.方法确诊为宫内早孕并要求终止妊娠的妇女200例,随机分为PG05组及米索组,于口服米非司酮150 mg后36 h,阴道放置PG05 0.5 mg或口服米索600μg,比较两组的疗效及副反应.结果两组完全流产率,不全流产率及失败率无统计学差异,PG05组的药流副反应轻于米索组,但排胎时间较长.阴道出血时间及出血量两组间无统计学差异.结论0.5 mg PG05配伍米非司酮是一种有效的终止早孕方案,在不降低完全流产率的前提下,降低药流副作用,减少痛苦,增加病人的依从性.     

卡前列甲酯栓与米索前列醇终止早孕的临床比较

目的:比较小剂量卡前列甲酯栓(卡孕栓,PG05)配伍米非司酮与米索前列醇(米索)配伍米非司酮终止早孕的疗效。方法:确诊为宫内早孕并要求终止妊娠的妇女200例,随机分为PG05组及米索组,于口服米非司酮150 mg后36 h,阴道放置PG05 0.5 mg或口服米索600μg,比较两组的疗效及副反应。结果:两组完全流产率,不全流产率及失败率无统计学差异,PG05组的药流副反应轻于米索组,但排胎时间较长。阴道出血时间及出血量两组间无统计学差异。结论:0.5 mg PG05配伍米非司酮是一种有效的终止早孕方案,在不降低完全流产率的前提下,降低药流副作用,减少痛苦,增加病人的依从性。     

小剂量卡孕栓在未产妇女中早期人工流产术中的应用

目的探讨小剂量卡孕栓在未产妇女中早期人工流产术中的应用。方法选取要求终止妊娠无用药禁忌证及人工流产禁忌证的健康未产妇女120例,随机分为观察组和对照组各60例。观察组取膀胱截石位,将0.5mg卡孕栓置于阴道后穹窿,平卧15min后站立,60min后行负压吸宫术。对照组未应用任何药物,直接行负压吸宫术。术中用宫颈扩张器测量宫颈扩张程度(mm),并测量出血量,观察置入卡孕栓后出现的各种异常表现。结果观察组应用卡孕栓后于术中测量宫颈内口已扩张至6.0～7.5mm者46例(76.67%),对照组宫颈内口自然扩张6.0～7.0mm者17例(28.33%),2组经统计学处理有统计学意义(P<0.005)。结论对于行早期人工流产术者于术前应用小剂量卡孕栓0.5mg置于阴道后穹窿部进行术前扩张软化宫颈,不良反应小,效果确切。     

卡孕栓在钳刮人工流产术前的应用

钳刮人工流产术 (简称钳刮术 )是避孕失败所采用的一种补救措施。以往采用机械扩张宫颈后行钳刮术。手术时患者较为痛苦 ,且并发症发生率较高。我院自1997年 6月以来对人流术者在行钳刮术前数小时于阴道后穹窿放置卡孕栓 ,使宫颈充分扩张 ,取得良好的效果 ,现报道如下。1　资料与方法1.1　资料　 1997年 6月～ 1999年 6月对12 2例孕 10～ 16周要求终止妊娠者行钳刮术。年龄最小 18岁 ,最大 42岁 ,平均 2 6岁 ,其中 2 0～ 30岁年龄组占 89%。随机分为观察组 6 4例 ,对照组 5 8例。查 12 2例凝血功能均正常 ,无禁忌症。1.2　方法　观察组 :　…     

卡孕栓在人工流产术前的应用分析

目的探讨人工流产术前应用卡孕栓的效果。方法选择200例要求终止早孕的妇女，试验组100例，在人工流产术前2h阴道后穹隆放置卡孕栓1枚，100例为对照组，观察临床效果。结果试验组宫颈软化程度、宫口扩张程度优于对照组，人工流产综合征的发生率、手术时间及出血量均少于对照组。结论人工流产术前应用卡孕检安全可靠，值得推广。     

米索前列醇在初孕人工流产术前应用疗效观察

<正>人工流产作为意外怀孕的补救措施,是计划生育门诊的常规手术。2009年1月—2010年12月笔者在人工流产术前1 h给予早孕妇女口服米索前列醇,效果满意,现报道如下。1资料与方法1.1一般资料在我院计划生育门诊拟行人工流产术的妇女386例,均为初孕,孕45～70 d,排除其他     

米非司酮配伍米索前列醇及卡孕栓终止10～18周妊娠

近年来,国内大量临床研究证明米非司酮配伍前列腺素类似物能有效终止早孕,且不仅用于终止停经49d以内,也有用于停经7～16周,14～24周妊娠的报道[1,2],但药物配伍剂量与给药方案各不相同。本文将米非司酮配伍米索前列醇及前列醇联合卡孕栓用于终止10～18周妊娠,临床收到了令人满     

Termination of early pregnancy by two regimens of mifepristone with misoprostol and mifepristone with PG05—a multicentre randomized clinical trial in China

A multicentre randomized open clinical trial was conducted to compare the efficacy and side effects of two regimens of mifepristone with misoprostol, and mifepristone with PG05 for termination of early pregnancy (amenorrhoea < = 49 days). Six-hundred women in early pregnancy, who requested medical abortion were randomly allocated into 3 groups. In group 1 (n = 301), an initial dose of mifepristone 50 mg was given, followed by 25 mg every 12 hours up to a total dose of 150 mg mifepristone, plus a single oral dose of misoprostol 600 μg in the morning of the third day. In group 2 (n = 150), the same regimen of mifepristone was given, but dl-15-methyl PGF₂ (PG05) 1 mg vaginal suppository was inserted on the third day. In group 3 (n = 149), a single dose of mifepristone 200 mg was given and misoprostol 600 μg was used as in group 1. The complete abortion rate were 94.4%, 97.3%, and 94.6% for group 1, 2 and 3, respectively. 3.0, 2.0 and 2.7% of women had incomplete abortion, and 1.7, 0.7 and 2.0% of women in the 3 groups were treatment failures; in the remaining 1% in group 1 and 0.7% in group 3, treatment outcome could not be determined. There were no significant differences among the 3 groups. Lower abdominal pain was the main complaint which was reported by 82% of the subjects after PGs administration. The incidence of diarrhoea in PG05 group (38.7%) was significantly higher than that in the other two groups (21.6 and 20.1%) (P < 0.001), and so was vomiting. It was concluded that misoprostol, as an orally effective prostaglandin, in combination with mifepristone for induced abortion of early pregnancy was as effective as PG05 vaginal suppository. Besides, it has advantages of convenience of use, less side effects, easy storage and transfer, and low cost.     

A randomized comparison of sublingual and vaginal misoprostol for cervical priming before suction termination of first-trimester pregnancy

This randomized trial compares the efficacy and side effects of sublingual and vaginal misoprostol for cervical priming before first-trimester pregnancy termination. One-hundred pregnant women between 6 and 12 weeks of gestation opting for termination of pregnancy by suction evacuation were included in this study. The women were randomly allocated into two groups. Group 1 received 400 microg of sublingual misoprostol and group 2 received 400 microg of vaginal misoprostol 2 h prior to suction evacuation. The abortion was carried out by suction evacuation using a Karman's cannula attached to an electrically operated suction machine under intravenous analgesia. Baseline cervical dilatation, duration of the procedure, operative blood loss, side effects and complications were noted in both groups. There was a significant difference between the sublingual and vaginal misoprostol groups with respect to mean cervical dilatation (8.6 mm vs. 6.8 mm, p < 0.05). However, the duration of the procedure (3.03 min vs. 3.16 min) and the amount of blood loss (29 mL vs. 31.2 mL) were not significantly different between the two groups. The women in the sublingual group experienced significantly more shivering and preoperative vaginal bleeding (68% vs. 56%, p < 0.05). None of the women in the two groups had either uterine perforation or excessive hemorrhage. In our study, sublingual misoprostol (400 microg) was significantly more effective in facilitating cervical dilation prior to surgical abortion than vaginal misoprostol.     

A comparison of tamoxifen and misoprostol to misoprostol alone for early pregnancy termination

A study was undertaken to determine whether the combination of oral tamoxifen and moistened misoprostol administered vaginally was superior to that of placebo and moistened misoprostol administered vaginally for elective termination of early pregnancies.

A clinical trial was conducted with a study group of 150 healthy women with pregnancies of ≤56 days gestational age who desired pregnancy termination. Subjects were randomized to ingest either 20 mg of tamoxifen (group 1) or placebo (group 2) twice daily for 1 day, followed 48 h later by vaginal administration of 800 μg of saline-moistened misoprostol. This dose of misoprostol was repeated 24 h later and 8 days later if an abortion had not occurred. The main outcome measures were incidence of complete abortion, hemoglobin levels, duration of vaginal bleeding, and incidence of side effects. Complete abortion occurred in 709 (93.3%) in group 1 and 68 (90.7%) in group 2. There were no differences in either group between earlier (≤49 days) and later (50–56 days) gestations. The mean duration of uterine bleeding was 7.9 days and 8.2 days in group 1 and group 2, respectively. In group 1, 94.3% who aborted bled for <14 days, and in group 2, 95.6%. No subject required a blood transfusion. There were no significant differences in side effects between the two groups. These data suggest that pretreatment with tamoxifen is not necessary when using moistened vaginal misoprostol for abortion of pregnancies of ≤56 days of gestation.     

米非司酮、米索前列醇、PG05用作宫颈扩张剂临床随机比较试验

132例早孕对象(停经≤70天)随机分成四组。组Ⅰ服米非司酮25mg,12小时一次连服4次,48小时后行人流术;组Ⅱ服米索前列醇4片,3小时后行人流术;组ⅢPG05 1mg,阴道后穹窿给药2小时后行人流术;组Ⅳ对照组,人流术前不用药。结果显示:宫颈扩张度组Ⅰ为6.56±1.00(mm),组Ⅱ为6.82±0.98(mm);组Ⅲ6.82±1.07(mm);组IV 5.17±0·76(mm)。用药组均与对照组在统计学上有显著差异(PM相似文献   

米非司酮、丙酸睾丸酮分别配伍卡孕栓及米非司酮配伍米索前列醇终止10～16周妊娠的随机对比研究

148例10～16周妊娠妇女,按随机表分为A、B、C三组。A组:米非司酮配伍卡孕栓;B组:丙酸睾丸酮配伍卡孕栓;C组:米非司酮配伍米索前列醇。结果:米非司酮配伍卡孕栓组终止妊娠成功率为100％,平均引流产时间为7.78±1.02h;丙酸睾丸酮配伍卡孕栓终止妊娠成功率为89.8％,平均引流产时间为10.69±0.81b;两组之间差异显著(P<0.05)。卡孕栓用量,A组平均3.63±0.19mg,B组平均4.49±0.13mg,两组之间差异非常显著(P<0.01)。米非司酮配伍米索前列醇终止妊娠成功率为88％,和A组相比差异显著(P<0.05),平均引流产时间为9.64±1.89h,与A、B两组相比无显著差异。结论:米非司酮配伍卡孕栓用于终止10～16周妊娠效果明显优于其它两组,可为终止此期妊娠的较理想方法。     

Flexible mifepristone and misoprostol administration interval for first-trimester medical termination

Background

The administration interval between mifepristone and misoprostol is usually about 36-48 h, which might affect a woman's choice of method of termination. Unwanted outcomes such as uterine bleeding, painful cramps and psychosocial issues which may occur during this long interval can be altered by a shorter administration interval. A shorter interval will be cost-effective as it saves both women's and clinician's time and other resources. If the waiting time interval between therapeutic interventions could be reduced without compromising efficacy, it will potentially improve compliance, patient acceptability and quality of care.

Study design

A systematic review of randomized controlled trials published from 1999 to 2008 was conducted to assess the evidence for a shorter mifepristone and misoprostol administration interval at first trimester medical termination. Searching strategy included MEDLINE, EMBASE, CLINAHL and Cochrane Library. The primary outcome measure was complete abortion without the need for a surgical procedure.

Results

Five randomized controlled trials (RCT) compared the efficacy of mifepristone and misoprostol administration intervals between 0 and 72 h in 5139 participants. The complete abortion rates varied between 90% and 98%. Although the meta-analysis of pooled data of all RCTs shows no statistically significant difference in efficacy between the shorter and longer dosing intervals, there is a trend toward slightly lower success rates with administration intervals earlier than 8 h.

Conclusions

Overall efficacy of complete abortion is not statistically different between the longer and shorter administration intervals. This might encourage the clinician to adopt a ‘flexible policy’ with fully informed consent and consideration of all circumstances.     

Sublingual misoprostol for preabortion cervical ripening in first-trimester pregnancy termination

The objective of this prospective randomized placebo-controlled study was to determine the efficacy of sublingual misoprostol in facilitating cervical dilatation before surgical abortion in first trimester pregnancy. Sixty healthy pregnant women between 6 and 11 weeks of gestation opting for voluntary medical termination of pregnancy at All India Institute of Medical Sciences hospital were included in this study. Women were randomized to two groups, the study group (n = 30) received 400 micro g of sublingual misoprostol and the control group (n = 30) received placebo, 2 h prior to surgical abortion. Using Hegar's dilators, cervical dilatation prior to vacuum aspiration was measured. Other parameters assessed included the total time required for the procedure, intraoperative blood loss and associated side effects. The mean cervical dilatation in the misoprostol group was 7.7 mm as compared to 3.4 mm for placebo group. The average time required for pregnancy termination was significantly shorter (p < 0.001) in the misoprostol group. The procedure-related blood loss was also significantly decreased in the misoprostol group. However, side effects including pre-evacuation vaginal bleeding, lower abdominal pain, nausea and vomiting were significantly higher in the misoprostol group than in placebo group (p < 0.005). There was no case of hemorrhage or uterine perforation in either group. Sublingual misoprostol is effective in facilitating cervical dilatation prior to surgical abortion. Its usage significantly decreased the time of surgical evacuation and minimized blood loss during the procedure.     

米非司酮配伍卡前列甲酯栓终止早孕的临床研究

<正> 本文报道我院应用米非司酮配伍卡前列甲酯栓(PG05)终止早孕的效果、临床特点及副反应。 材料与方法 一、药物 1.米非司酮 25mg/片,由上海华联制药公司