米非司酮用于足月妊娠引产胎盘电镜观察及定量分析

目的了解小剂量米非司酮(100mg)用于足月妊娠引产时胎盘超微结构的变化.方法对20例米非司酮配伍米索前列醇引产,20例单用米索前列醇引产,20例自然临产,无明显并发症及合并症,经阴道分娩的足月初产妇胎盘进行透射电镜观察并通过图像分析仪对胎盘超微结构进行体视学分析.结果米非司酮组需用米索前列醇的次数较单用米索前列醇组明显减少.合体滋养细胞、细胞滋养细胞、蜕膜细胞、绒毛中毛细血管内皮细胞的超微结构在三组间未发现明显不同@结论足月孕妇口服米非司酮100mg配伍米索前列醇引产对胎盘无明显影响,并未造成胎儿、胎盘缺血缺氧性损害.     

米非司酮配伍米索前列醇在12～20周妊娠引产中的应用

目的 探讨米非司酮配伍米索前列醇用于中期妊娠引产的可行性。方法 对56例中期妊娠要求引产的孕妇，用口服米非司酮然后阴道上米索前列醇的方法进行引产，以23例同样条件的孕妇用利凡诺引产为对照。结果 米非司酮组较利凡诺组引产所需时间缩短，胎盘娩出更完整，产后出血减少，两者差异有显著性。结论 米非司酮配伍米索前列醇用于中孕引产安全、方便、可靠。     

米非司酮配伍米索前列醇对孕12～24周引产的临床观察

目的 探讨米非司酮配伍米索前列醇用于孕12～24周引产的临床效果。方法 回顾性分析米非司酮配伍米索前列醇对孕12～24周引产的效果和副作用，并与依沙吖啶引产效果进行比较。结果 引产成功率98．5％，显著高于依沙吖啶引产的85．5％，产程较依沙吖啶短，胎盘胎膜残留量显著降低。结论 米非司酮配伍米索前列醇用于中期妊娠引产，是一种安全、有效、痛苦小、并发症少的方法。     

妊娠中期前置胎盘引产方式探讨

目的:探讨妊娠中期前置胎盘引产方式的特点及影响因素。方法:回顾分析于南京市妇幼保健院产科引产的前置胎盘状态的孕妇(14～27⁺⁶周)共94例。根据引产方式将孕妇分为米非司酮+米索前列醇组(10例)、米非司酮+乳酸依沙吖啶羊膜腔注射组(61例)、剖宫取胎术组(23例),比较3组孕妇的一般情况、引产结局。根据前置胎盘类型将患者分为完全性前置胎盘组(47例)和非完全性前置胎盘组(47例),比较2组间患者引产转归。根据是否采用子宫动脉栓塞(UAE),进一步将药物引产患者分为药物引产组(46例)和药物引产+UAE组(25例)。结果:完全性前置胎盘病例中,米非司酮+米索前列醇组中完全性前置胎盘比例最低,米非司酮+乳酸依沙吖啶羊膜腔注射组其次,剖宫取胎术组完全性前置胎盘比例最高。米非司酮+米索前列醇组的引产孕周[15.8周(13.9,17.33)]显著早于米非司酮+乳酸依沙吖啶羊膜腔注射组[20.7周(18.3,23.7)]和剖宫取胎术组[20.7周(18.3,23.7)],3组间比较差异有统计学意义(P=0.002)。3组间在引产时出血量具有显著差异,剖宫取胎术组引产时出血量...     

米非司酮用于晚期妊娠促宫颈成熟203例临床分析

本文随机对照研究 ,观察比较米非司酮配伍米索前列醇及小剂量催产素用于足月妊娠促宫颈成熟的临床效果及对胎儿的影响 ,现分析报告如下。1　资料与方法1 1　观察对象　 1998年 2月至 1999年 12月我院产科住院的单胎、头位孕妇 ,因各种原因需要引产者 2 73例 ,随机分为两组。 2 0 3例为研究组 ,应用米非司酮 15 0ｍｇ ,治疗 1天后给予米索前列醇引产 ;70例为对照组 ,给予催产素引产。全部观察对象年龄在 2 1～ 31岁之间 ,均无严重并发症 ,研究组无前列腺药物使用禁忌证。引产指征为妊高征 ,延期或过期妊娠 ,羊水过少 ,肝内胆汁淤积症等需要终…     

米索前列醇用于足月妊娠引产剂量分析

近年来 ,有不少报道米索前列醇用于足月妊娠引产的临床分析 ,而剂量各家报道不一。为了探讨米索前列醇用于足月妊娠引产最适宜剂量 ,我们对 68例足月妊娠孕妇采用阴道置米索前列醇引产 ,剂量分别为 2 5 μｇ或 5 0 μｇ ,观察其临床效果 ,现总结如下。1　资料与方法1 1　一般资料　我院于 1998年 10月至 1999年 8月间 ,对因各种原因需行引产的单胎头位的足月孕妇共 68例 ,经阴道检查排除产道异常 ,无明显头盆不称 ,无米索前列醇禁忌证者随机分两组 :Ⅰ组 3 3例 (初产妇 3 0例 ,经产妇 3例 )阴道置米索前列醇 2 5 μｇ ;Ⅱ组 3 5例 (初产妇 3…     

两种紧急避孕方法比较性研究

目的 :比较不同低剂量米非司酮配伍米索前列醇与单服米非司酮用于紧急避孕的效果及其副反应。方法 :运用随机双盲多中心临床比较 ,研究 899例健康妇女在无保护性性交后 1 2 0 h内 ,随机分为 3组。组 (3 0 0例 ) :口服 2 5 mg米非司酮 ,2 4 h后口服 0 .2 mg米索前列醇 ;组 (2 99例 ) :口服 1 0 mg米非司酮 ,2 4 h后口服 0 .2 mg米索前列醇 ;组 (3 0 0例 ) :单服米非司酮 1 0 mg。按 Dixon法推算避孕有效率。结果 :899例妇女中总妊娠数 1 1例 :组 2例 ,组 2例 ,组 7例 ;方法失败 :组 1例 ,组 0例 ,组 5例 ;避孕有效率分别为 95 .5 %、1 0 0 %、76 .9%。组 加组 与组 相比有极显著差异 (P<0 .0 1 )。副反应较轻均可耐受 ,无严重副反应。米非司酮配伍米索前列醇与单服米非司酮组间副反应也无显著差异。结论 :应用低剂量米非司酮和米索前列醇作为紧急避孕是有效安全的紧急避孕方案 ,且对月经周期无明显干扰。     

米索前列醇不同给药途径中期引产的效果观察

1资料与方法1．1一般资料1996年10月至1998年2月,因各种原因要求引产的单胎中期妊娠132例,全部住院引产。年龄最小16岁,最大41岁,平均27．5岁;已婚95例,未婚37例;初产力例,经产62例;均无弓产禁忌证。1．2用药前检查血型,出、凝血时间,血、尿常规,肝肾功能,心电图,B超检查胎儿大小、胎盘位置、羊水深度。回．3用药方法A组：口服米非司酮及米索前列醇组（6例）。早6时服米非司酮509,晚6时服259,共2天,第3天早6时眼米索前列醇400ng,以后隔3小时服1次,最多服药4次。B组：米非司酮口服及米索前列醇阴道放药组（7例）。米非…     

米非司酮联合米索前列醇在瘢痕子宫中期引产中的疗效分析

目的探讨米非司酮联合米索前列醇在瘢痕子宫中期引产中的疗效及安全性。方法回顾性分析58例瘢痕子宫妊娠中期(妊娠16~26周)引产患者的临床资料。其中采用米非司酮联合米索前列醇32例(米索前列醇组),米非司酮联合依沙吖啶羊膜腔穿刺术26例(依沙吖啶组),比较两组的引产时间、引产成功率、产后清宫率和产后出血量等情况。结果米索前列醇组的引产时间[(27.30±3.26)h]与依沙吖啶组[(31.90±4.28)h]比较,差异有统计学意义(P0.05)。米索前列醇组引产成功率和产后清宫率分别为100%(32/32)和37.50%(12/32),依沙吖啶组分别为88.46%(23/26)和92.31%(24/26),两组比较,差异均有统计学意义(P0.05),两组产后出血量比较,差异无统计学意义(P0.05)。两组均无严重并发症发生。结论米非司酮联合米索前列醇引产可用于瘢痕子宫中期引产,且相对安全有效。     

三种终止中期妊娠方法的比较研究

在中期妊娠引产的临床过程中,先后采用利凡诺,米非司酮配伍米索前列醇,米非司酮配伍米索前列醇联合利凡诺三种配方方法终止中期妊娠引产,比较了它们的引产效果,用药后相应副作用以及用药后并发症的情况,结果表明:在米非司酮配伍米索前列醇或米非司酮配伍米索前列醇联合利凡诺终止中期妊娠的临床试验中,与单独使用利凡诺相比较,不仅缩短了总产期,减轻了患者第一第二产期的疼痛程度,而且减少了产时产后出血量,提高了经济效益和社会效益,也减少了引产后的清宫率。两种方法均值得推广。     

Mifepristone and misoprostol in the induction of labor at term.

OBJECTIVE: To assess the ability of mifepristone to prime the cervix adequately and induce labor in pregnant women at term; and when mifepristone alone proves insufficient, to determine whether oral misoprostol taken 48 h following mifepristone administration is effective in inducing labor. METHODS: In this prospective study 50 pregnant women at term with an unfavorable cervix were given 400 mg of mifepristone orally and allowed to return home. If labor did not start within 48 h, the women were admitted and induction was continued with 50 mug of misoprostol, a prostaglandin (PG) E1 analogue, taken orally every 4 h. The 50 controls, who were matched prospectively for parity and pregnancy duration, underwent labor induction according to the routine administration of 3-mg tablets of PGE2 vaginally. RESULTS: In the study group, 66% of the women entered labor spontaneously or had a sufficiently ripened cervix within 48 h of taking mifepristone. However, there was no difference in time between prostaglandin administration and delivery between the control group and the 34% of women who required misoprostol in the study group. In the study group, the cesarean section rate was significantly lower among the women whose labor was induced with mifepristone alone than among those who required misoprostol. There were no differences overall in obstetric or neonatal outcomes between the study and control groups. CONCLUSIONS: In this pilot sample, 400 mg of mifepristone was effective in inducing cervical changes and labor. Although there were no adverse effects using oral misoprostol in combination with mifepristone, labor was more difficult to induce in the women who did not respond to mifepristone alone, and these women had a higher operative delivery rate.     

Comparison of mifepristone combination with misoprostol and misoprostol alone in the management of intrauterine death: condensation - misoprostol and mifepristone combination is more effective than misoprostol alone in the management of intrauterine death

ObjectivesTo compare the efficacy and safety of misoprostol and mifepristone combination with misoprostol alone in management of intrauterine death.Materials and MethodsIt is a prospective study carried out in 40 pregnant women admitted with intrauterine death after 28 weeks of gestation at a tertiary care referral centre divided into two groups of 20 each. Every alternate patient was assigned Group I and Group II. Group I (combination group) – the women received 200 mg of mifepristone; and after 36 hours, misoprostol was administered orally (100 μg if pregnancy was <37 weeks and 50 μg if pregnancy was >37 weeks) for every 3 hour till they went into active labor for a maximum of four doses. Group II (misoprostol group) – Women received oral misoprostol (100 μg if pregnancy was <37 weeks and 50 μg if pregnancy was >37 weeks) for every three hours till she went into active labor for maximum of four doses.Primary outcome measures were achievement of successful induction and induction delivery interval (IDI). Women who did not deliver after four doses of misoprostol were considered as failure. In all the women, bishop score before the start of mifepristone and misoprostol, induction delivery interval, and adverse effect of the drug were noted. Data were analyzed by using Student t test and Chi-square test.ResultsIn the Group I, 60% of women, delivered with mifepristone alone. The rest of the patients [8 (40%)] had significant improvement of the bishop score after 36 hour. Parity, gestation, and bishop score did not affect the success of induction in the Group I. IDI was significantly less in the Group I (6.72 ± 3.34) as compared with that of the Group II (11.81 ± 6.33). Parity, gestation, and bishop score did not affect the IDI in the two groups. Number of doses of misoprostol required were significantly less in patients who were pretreated with mifepristone.ConclusionCombination of mifepristone and misoprostol is more effective than the misoprostol alone for induction of labor in women with intrauterine death.     

可控释地诺前列酮栓与米索前列醇及Foley尿管用于足月妊娠促宫颈成熟及引产的效果及安全性比较

Objective?To explore the effects and safety of controlled-release dinoprostone suppositories, misoprostol and Foley catheters for full-term pregnancy in promoting cervical ripening and induce labor. Methods?86 full-term pregnant primiparas with cervical Bishop score<6 and indications for labor induction were prospectively selected and admitted between May 2020 and August 2021. They were divided into 3 groups according to the internal sampling method, 29 cases as group A were treated with controlled-release dinoprostone suppositories, 27 cases as group B were treated with misoprostol, and 30 cases as group C were treated with Foley catheters. The treatment effects and safety of the three groups were compared. Results?The time from induction to labor and the time from labor induction to delivery in group A and C were shorter than those in group B (P＜0.05), and the success rate of induction was higher than that in group B (P＜0.05). The cervical Bishop scores after administration of 4 h, 12 h and 24 h were all higher than group B (P＜0.05). Conclusion?Compared with misoprostol, the controlled-release dinoprostone suppository and Foley catheter are more suitable for full-term pregnancy induction, which can promote cervical ripening and increase the success rate of labor induction.     

米非司酮联合米索前列醇用于终止早期妊娠和治疗稽留流产的效果比较

目的：探讨并比较米非司酮联合米索前列腺醇用于终止早期妊娠和治疗稽留流产的效果和安全性。方法：选择2008年5月至2013年5月于我院就诊的孕10～16周要求终止妊娠和稽留流产病例为研究对象,分为早期妊娠组和稽留流产组,两组患者均给予同剂量的米非司酮和米索前列腺醇序贯治疗,观察和比较两组患者的流产效果以及不良反应。结果：稽留流产组患者的完全流产率低于早期妊娠组,胎体排出后24h阴道出血量多于早期妊娠组,差异有统计学意义（P〈0．05）,但两组患者口服米索前列腺醇到胎体排出的时间间隔及不良反应差异无统计学意义（P〉0．05）。结论：米非司酮联合米索前列腺醉用于治疗稽留流产效果和安全性值得肯定。     

Misoprostol-only versus mifepristone plus misoprostol in induction of labor following intrauterine fetal death

BACKGROUND: Both misoprostol-alone and a combination of mifepristone plus misoprostol have been used in induction of labor in cases of intrauterine fetal death (IUFD). METHODS: Data from 130 women with IUFD at 21-42 weeks of gestation were analysed retrospectively. A total of 82 women received 100 microg (median) of misoprostol at 4-h intervals. Some 48 women received 200 mg of mifepristone, followed 19 h (median) later by single doses of 25 microg of misoprostol at 4-h intervals. RESULTS: The induction-to-delivery time did not differ between the groups (13.3 versus 12.8 h). However, between 21 and 25 weeks of gestation, the induction-to-delivery time was shorter with the combination regimen (p=0.04). The total dose of misoprostol needed was lower in the group pre-treated with mifepristone (p=0.0028). The 2 groups did not differ as regards complications experienced during labor and delivery. CONCLUSIONS: Both regimens, misoprostol-only and the combination of mifepristone and misoprostol, are effective and safe in induction of labor after IUFD. Pre-treatment with mifepristone is more effective at earlier gestational weeks.     

The combination of mifepristone and misoprostol for the termination of pregnancy

The combination of 200 mg of mifepristone followed by 25 μg to 800 μg (depending on gestational age) of misoprostol has been shown to be effective for the termination of pregnancy throughout gestation. The dose of misoprostol should be reduced as gestational age increases. Mifepristone is not indicated for induction of labor with a live fetus because there are no data to confirm that it does not have a possible deleterious fetal effect. The course of treatment and prerequisites for medical abortion and recommended mifepristone and misoprostol regimens for different gestational ages are described, along with the side effects, management of complications, and postabortion care. The use of the mifepristone-misoprostol combination regimen for induction of labor in cases of fetal death is also described.     

Oral misoprostol versus mifepristone for cervical dilatation before vacuum aspiration in first trimester nulliparous pregnancy: a double blind prospective randomised study

Objective To compare the effectiveness of oral misoprostol and mifepristone for cervical priming before first trimester termination of nulliparous pregnancy.
Design Prospective double blind randomised study.
Setting Department of Obstetrics and Gynaecology, University of Hong Kong.
Participants One hundred nulliparous women undergoing termination of pregnancy between 8 and 12 weeks of gestation were recruited for this prospective randomised trial. The women were allocated to either the oral misoprostol or mifepristone group. Subjects in misoprostol group were given placebo and misoprosto1 400 pg 36 h and 12 h respectively before vacuum aspiration. Subjects in mifepristone group were given 200 mg mifepristone and placebo 36 h and 12 h respectively prior to operation.
Main outcome measures Baseline pre-operative cervical dilatation, the incidence of side-effects, the amount of blood loss and duration of procedure.
Results There were no significant differences in the baseline cervical dilatation, incidence of side-effects, amount of blood loss and duration of procedure.
Conclusions Misoprostol and mifepristone are of similar effectiveness for cervical priming prior to vacuum aspiration in nulliparous women. Misoprostol has additional advantages of being widely available and inexpensive.     

Mifepristone in second-trimester medical abortion: a randomized controlled trial

OBJECTIVE: To investigate the adjunctive use of mifepristone in second-trimester induction abortions using misoprostol 1 day after feticidal digoxin. METHODS: This is a randomized, placebo-controlled, double-blind trial of mifepristone in second-trimester induction termination using misoprostol after feticidal digoxin. Women seeking abortion between 18 and 23 weeks of gestation were offered enrollment. At the time of digoxin amnioinfusion, participants received a randomly allocated, identical-appearing capsule containing either mifepristone, 200 mg, or placebo. Patients returned the following day for induction with buccal misoprostol. The primary outcome was the time interval from the first misoprostol dose to abortion. Analysis utilized survival curves with log-rank testing. RESULTS: Of 64 women, 32 received mifepristone and 32 received placebo. The groups did not differ by ethnicity, age, parity, reason for termination, or gestational age. Median procedure time was significantly shorter for those who received mifepristone, 10 hours (95% confidence interval [CI] 8-12), than those who did not, 18 hours (95% CI 15-22), P<.01, and those parous, 10 hours (95% CI 9-14), compared with nulliparous, 16 hours (95% CI 12-22, P=.02). Other findings in the mifepristone compared with placebo group included rates of placental retention, 3.1% compared with 6.3% (P=.61), length of hospitalization, 0.66 days compared with 0.8 days (P=.23), and analgesic requirements, 27.2 mg compared with 39.3 mg morphine (P=.22). Side effects during induction were similar between groups. CONCLUSION: Addition of mifepristone in second-trimester termination inductions using misoprostol significantly reduces the abortion time interval. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, www.clinicaltrials.gov, NCT00382538 LEVEL OF EVIDENCE: I.     

延长米非司酮配伍米索前列醇序贯用药时间预防流产后出血的 …

目的 探讨米非司酮配伍米索前列醇终止早孕的最佳剂量方案,以预防流产后出血,方法 对１６１２例妊娠≤４９天,要求药物终止妊娠的妇女,按２：１随机分为观察组,对照组。观察组１１８例,米非司酮首次剂量５０ｍｇ,继后每１２ｈ１次,每次２５ｍｇ（共６ｄ）,总剂量３００ｍｇ,于用药第３天晨加用米索前列醇６００μｇ,第４￣６天晨各加服２００μｇ,总量１２００μｇ。对照组４９４例,米非司酮首次剂量５０ｍｇ,继后第     

米非司酮配伍米索前列醇终止畸形子宫早孕63例临床分析

目的 :探讨米非司酮配伍米索前列醇终止畸形子宫早孕的临床疗效。方法 :对 6 3例早孕合并畸形的流产病例均采用药物流产方法 ,即 :米非司酮 75mg× 2 (早 50 mg,晚 2 5mg)口服 ,d 3晨空腹服米索前列醇 6 0 0μg。结果 :完全流产率 44 /6 3(6 9.8% ) ,不全流产率 1 7/6 3(2 7.6 % ) ,失败 2 /6 3(3.2 % )。对 1 7例不全流产、2例失败者行刮宫及吸宫术 ,手术操作容易 ,穿孔率及漏吸率为 0。B超用于诊断畸形子宫正确率高。结论 :米非司酮配伍米索前列醇终止畸形子宫早孕的方法较理想 ,B超是诊断子宫畸形较理想的手段