降低米非司酮和米索前列醇剂量催经止孕效果观察

目的：观察降低米非司酮与米索前列醇剂量催经止孕的临床效果。方法：将120例闭经时间≤37 d的妇女随机分为2组（各60例）。低剂量组：给予米非司酮100 mg口服,米索前列醇400 μg舌下含服;常规剂量组：给予米非司酮150 mg,米索前列醇600 μg口服。比较给药后2组的完全流产率、出血时间、平均流产时间和不良反应的程度。结果：测定血清人绒毛膜促性腺激素β亚单位（β-hCG）诊断低剂量和常规剂量组分别有3例和2例未妊娠,给药后均引发阴道出血（即月经来潮）。2组完全流产率、出血时间差异无统计学意义（P ＞0.05）;常规剂量组平均流产时间短于低剂量组（P ＜0.05）;低剂量组不良反应发生率低于常规剂量组 （P ＜0.05）。结论：降低米非司酮和米索前列醇剂量用于闭经≤37 d催经止孕可行,且不良反应少。     

米非司酮合并米索前列醇催经止孕的多中心临床研究

米非司酮合并米索前列醇催经止孕的多中心临床研究吴学浙庄留琪邵敬於杜明昆周孝吾顾惠珍在预期月经来潮前后进行催经止孕治疗，可及早解除要求计划生育妇女的心理负担，避免进行人工流产术或药物终止妊娠带来的弊病。本研究通过小剂量米非司酮合并米索前列醇（米索）与更...     

米非司酮合并米索前列醇催经止孕的临床研究

米非司酮合并米索前列醇催经止孕的临床研究钱美玲，陶承洁，周美蓉（上海市卢湾区妇幼保健院，上海，２０００２０）本研究旨在了解小剂量米非司酮配伍米索前列醉于预期月经来潮前４天至预期月经来潮日及月经延期４天之内口服，用于催经止孕的临床效果及副反应。对象与方...     

复方米非司酮终止早孕的临床观察

目的：探讨复方米非司酮配伍米索前列醇药物流产的米非司酮配伍米索前列醇药物流产效果。方法：102例研究对象随机分为对照组50例,施行常规药物流产；观察组52例,服用复方米非司酮1片/d(米非司酮30 mg+双炔失碳酯5 mg)×2 d,24 h后,口服米索前列醇600μg,观察流产效果。结果：观察组和对照组药物流产成功率和流产后转经时间相似(P＞0．05),与对照组比较,观察组孕囊排出时间及流产后出血时间均明显缩短,流产时出血量减少(P＜0．05)。结论：60 mg米非司酮配伍10 mg双炔失碳酯,保持了常规150 mg米非司酮同等的临床疗效,由于大幅降低了米非司酮用量,减少了副作用。     

米非司酮配伍米索前列醇终止早孕不良反应分析

目的：观察探讨米非司酮配伍米索前列醇终止早孕的临床效果及不良反应,总结其临床应用价值。方法：选取我院2009年4月至2011年4月自愿要求终止妊娠的孕妇180例,随机分为观察组（米非司酮配伍米索前列醇治疗）和对照组（人工钳刮术）各90例,观察对比两组终止妊娠的效果及不良反应情况。结果：两组流产时间、阴道流血量、妊娠物排除时间对比,差异显著（P〈0.05）,具有统计学意义。两组孕妇的完全流产率、清宫率、流产后感染发生率及不良反应率对比差异显著（P〈0.05）,具有统计学意义。结论：米非司酮配伍米索前列醇用于计划生育终止早孕的临床效果确切,操作简便、不良反应小,安全可靠、值得在临床上广泛推广。     

米非司酮联合米索前列醇在瘢痕性子宫早孕中的应用效果

目的 探讨米非司酮联合米索前列醇在瘢痕性子宫早孕中的应用效果。方法 选取60例药物流产早孕患者为研究对象,以是否存在瘢痕性子宫划分为两组,非瘢痕性子宫早孕为常规组,瘢痕性子宫早孕为试验组。所有患者均采用米非司酮联合米索前列醇治疗,比较两组的流产情况、孕囊排出时间、流产后出血时间、流产24 h后出血量。结果 两组完全流产率比较差异无统计学意义（P>0.05）;两组孕囊排出时间、流产后出血时间及流产24 h后出血量比较差异无统计学意义（P>0.05）。结论 米非司酮联合米索前列醇在瘢痕性子宫早孕中的应用效果显著,整体治疗作用突出,流产效果理想,值得推广。     

米非司酮配伍米索前列醇不同给药间隔终止8~13周妊娠的临床比较

目的:比较米非司酮配伍米索前列醇不同给药间隔终止8~13周妊娠的药物流产效果。方法:将北京市西城区妇幼保健院妇产科2012年1月至2015年5月住院,自愿要求药物终止妊娠的的孕8~13周208例孕妇随机分为组1(46例)、组2(49例)、组3(50例)、组4(63例)。各组孕妇顿服米非司酮200 mg后,分别于1、12、24、36小时阴道放置米索前列醇0.6 mg,观察并随访首次使用米非司酮、米索前列醇到胚胎排出时间及流产效果,流产后2小时及24小时的出血量,流产后出血时间及月经恢复时间,服药后的不良反应,月经复潮后患者的满意度。结果:首次使用米索前列醇到胚胎排出时间、流产成功率组1与其他3组比较差异有统计学意义(P0.05),组2、3、4间比较差异无统计学意义(P0.05)。首次使用米非司酮到胚胎排出时间4组间两两比较差异均有统计学意义(P0.05),随两药间隔时间增加而延长。208例孕妇的药物流产成功率为93.8%(195例),其中完全流产80.0%(156例),不全流产20.0%(39例),失败率6.3%(13例)。流产后2小时、2~24小时的出血量及流产后出血时间、月经恢复时间各组间比较差异无统计学意义。米非司酮与米索前列醇使用间隔时间越长,两药间隔期间发生恶心、呕吐的比例增高,且有统计学差异(P0.05)。各组在腹泻、发热等不良反应方面差异无统计学意义(P0.05)。在满意度调查方面,非常满意和满意的占86%,不满意者占14%;组4的非常满意和满意度低于其他3组。结论:米非司酮配伍米索前列醇终止8~13周妊娠时,两药间隔缩短至12~24小时,流产效果无减低,总的流产时间较短。     

米非司酮配伍米索前列醇治疗稽留流产疗效及不良反应发生率观察

目的探索米非司酮配伍米索前列醇治疗稽留流产疗效及不良反应发生率。方法 100例稽留流产患者为试验对象,采用数据库随机分组式,各50例,分别进行米非司酮治疗、米非司酮配伍米索前列醇治疗。结果观察组完全流产率(96.00%)、不良反应(2.00%)、阴道停止出血时间(4.85±1.98)d、出血量(72.16±8.46)ml均优于对照组(P<0.05)。结论对稽留流产患者实施米非司酮配伍米索前列醇治疗效果显著。     

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研究

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 16 12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1118例 ,米非司酮首次剂量 5 0mg ,继后每 12h 1次 ,每次 2 5mg(共 6d) ,总剂量 30 0mg ,于用药第 3天晨加用米索前列醇 6 0 0 μg,第 4～ 6天晨各加服 2 0 0 μg,总量 12 0 0 μg。对照组 494例 ,米非司酮首次剂量 5 0mg ,继后每 12h 1次 ,每次 2 5mg ,总剂量 15 0mg ,于用药第 3天晨加服米索前列醇 6 0 0 μg。 结果　观察组与对照组完全流产率分别为 98 39%和 88 0 6 % ;不全流产率 1 43 %和 10 73 % ,流产失败率为 0 18%和 1 2 1% (P <0 0 0 0 1)。两组出血时间分别为 (8 2± 2 8)d和 (12 3± 3 9)d(P <0 0 0 1) ,10d内止血率为 87 45 %和 5 7 47% (P <0 0 0 0 1) ,两组副反应比较 ,差异无显著性 (P >0 0 5 )。结论　低剂量分次服用并延长米非司酮并米索前列醇用药时间可提高完全流产率 ,缩短药物流产后出血时间 ,且不增加副反应     

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。     

米非司酮配伍米索前列醇终止10～16周妊娠的临床多中心随机比 …

目的 探讨米非司酮合并米索前列醇（米索）终止１０－１６周妊娠最佳剂量及最佳给药途径。方法 将来自上海２４所医院的２００７例孕１０－１６周要求药物终止妊娠的妇女,随机分成４种不同的治疗组。组Ｉ,５１１例,米非司酮７５ｍｇ每天１次,连服２天（总量１５０ｍｇ）第３天晨口服米索０．６ｍｇ,每３－４小时重复１次,最多３组,组ＩＩ：４９１例,非米司酮１００ｍｇ每天１次,连服２天（总量２００ｍｇ）米索用法同组Ｉ     

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.     

米非司酮配伍米索前列醇终止10～16周妊娠的临床多中心随机比较性研究

目的探索米非司酮合并米索前列醇（米索）终止１０～１６周妊娠最佳剂量及最佳给药途径。方法将来自上海２４所医院的２００７例孕１０～１６周要求药物终止妊娠的妇女,随机分成４种不同的治疗组。组Ⅰ：５１１例,米非司酮７５ｍｇ每天１次,连服２天（总量１５０ｍｇ）,第３天晨口服米索０．６ｍｇ,每３～４小时重复１次,最多３次;组Ⅱ：４９１例,米非司酮１００ｍｇ每天１次,连服２天（总量２００ｍｇ）,米索用法同组Ⅰ;组Ⅲ：５１９例,米非司酮用法同组Ⅰ,第３天晨阴道内放置米索０．６ｍｇ,每１２小时重复１次,最多３次;组Ⅳ：４８６例,米非司酮用法同组Ⅱ,米索用法同组Ⅲ。结果４组２４小时内的流产成功率分别为８８．６％、８９．４％、９０．９％和９４．０％。组Ⅳ的成功率明显高于组Ⅰ和组Ⅱ。２４小时内流产成功者米索的用量,阴道给药者比口服给药者明显减少（Ｐ＜０．００１）,胃肠道副反应发生率也明显降低（Ｐ＜０．０５）。结论口服米非司酮２００ｍｇ合并阴道放置米索,是较好的药物终止１０～１６周妊娠的方法,可作为一种常规方法推荐在临床应用。     

Management of late intrauterine death using a combination of mifepristone and misoprostol--experience of two regimens

OBJECTIVE: To determine the safety and effectiveness of managing intrauterine death after 24 weeks gestation using a combination of mifepristone and misoprostol. STUDY DESIGN: Two regimens are compared. Twenty-nine women (group one) were managed using a combination of oral mifepristone and vaginal/oral misoprostol. After a change in dosage and route of administration, a further 20 women were managed with oral mifepristone and vaginal misoprostol (group two). RESULTS: All women delivered vaginally. The mean induction to delivery interval in group one was 7 h compared with 10.2 h in group two. Group two experienced fewer gastrointestinal side-effects than group one. CONCLUSION: This study confirms that the combined use of mifepristone and misoprostol is a safe and effective way of managing IUD after 24 weeks gestation. Regimen one results in a shorter induction to delivery interval but is associated with a higher incidence of gastrointestinal side-effects.     

Regimens of misoprostol with mifepristone for early medical abortion: a randomised trial

OBJECTIVE: To compare the efficacy, adverse effects and acceptability of the three most common misoprostol regimens used with mifepristone for medical abortion. DESIGN: Randomised nonblinded trial. SETTING: Three clinics associated with major research universities in Canada; two in major urban areas and one in a periurban area. POPULATION: Women of reproductive age. METHODS: Consenting women presenting for abortion services with gestations less than 56 days and who met inclusion criteria were given 200 mg mifepristone orally and then randomised into three misoprostol study groups: (group I) 400 micrograms of oral misoprostol, (group II) 600 micrograms of oral misoprostol, and (group III) 800 micrograms of vaginal misoprostol. Misoprostol was self-administered at home 24-48 hours following mifepristone, and participants were instructed to take a second similar misoprostol dose at 24 hours after the initial dose if bleeding was less than a normal menstrual period. MAIN OUTCOME MEASURES: Successful abortion without surgery was 94.1%, with no significant differences across the three study groups (94.7% in group I, 93.4% in group II, and 94.3% in group III; P= 0.975). RESULTS: Efficacy and adverse effects did not differ significantly across the three study groups. Pain increased significantly across the study and the gestational age groups and was associated with lower acceptability. CONCLUSIONS: There appears to be a range of safe and effective options for early medical abortion with mifepristone including a choice between oral and vaginal administration of misoprostol.     

Preference and acceptability of oral versus vaginal administration of misoprostol in medical abortion with mifepristone

OBJECTIVES: To compare the experience of pain, need of analgesic interventions, preference and acceptability in medical abortion up to 49 days of amenorrhea with mifepristone and orally versus vaginally administered misoprostol. STUDY DESIGN: Ninety-seven women were randomised to oral misoprostol, n=48, or vaginal misoprostol, n=49. On day 1 of the study, both the groups received 600 mg of mifepristone. On day 3 of the study, one group received 0.4 mg of misoprostol orally and the other group received 0.8 mg of misoprostol vaginally. RESULTS: Even though oral administration of misoprostol seemed to be associated with a higher rate of gastrointestinal side effects, women in both the groups showed a clear preference towards the oral route of administration. The willingness to administer the misoprostol at home was also higher among the women in the oral group, which may in part depend on a more positive/less negative experience of the abortion. CONCLUSION: A majority of women prefer oral administration of misoprostol in early medical abortion.     

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     

Second trimester termination of pregnancy for fetal anomaly or death: comparing mifepristone/misoprostol to gemeprost

OBJECTIVE: To assess the effect of changing the regimen for second trimester induction of labour from gemeprost to mifepristone/misoprostol. DESIGN and SETTING: A retrospective study at a university teaching hospital over the 5-year period 1993-1997. SUBJECTS, METHODS and REGIMENS: 68 patients, 34 in the gemeprost group and 34 in the mifepristone/misoprostol group. The gemeprost group received 1mg vaginally every 3h to a maximum of five doses. The mifepristone/misoprostol group were pre-treated with 600 mg mifepristone orally followed by 800 microg misoprostol vaginally and then 400 microg orally every 3h to a maximum of four oral doses. MAIN OUTCOME MEASURES: Induction to abortion interval; delivery within 24h. RESULTS: The mifepristone/misoprostol group had a lower induction to abortion interval compared to the gemeprost group (median 8.9h versus 19.8h, respectively, p<0.01). The mifepristone/misoprostol regimen was more successful than the gemeprost regimen; 94% versus 68%, respectively, aborted without extra medical or surgical intervention, p=0.02. There were no significant differences in side effects, analgesia requirements or complications between the two groups. Three patients with previous Caesarean sections had a ruptured uterus; two from the gemeprost group and one from the mifepristone/misoprostol group. CONCLUSIONS: The new mifepristone/misoprostol regimen was more effective in second trimester induction of labour. Induction of labour with misoprostol or gemeprost should be used with care in patients with a previous Caesarean section.     

Early pregnancy termination with intravaginally administered sodium chloride solution-moistened misoprostol tablets: historical comparison with mifepristone and oral misoprostol

OBJECTIVE: The purpose of this study was to compare the abortifacient effect of intravaginally administered moistened misoprostol tablets with that of the combination regimen of mifepristone and oral misoprostol. STUDY DESIGN: One hundred women at 相似文献