米非司酮配伍米索前列醇治疗稽留流产45例疗效分析

目的探讨米非司酮配伍米索前列醇治疗稽留流产的临床疗效。方法将1999年1月～2004年1月在我院确诊为稽留流产的患者90例，随机分成观察组和对照组各45例。观察组口服米非司酮配伍米索前列醇；对照组口服己烯雌酚。结果观察组完全流产率40％，不完全流产率60％；对照组完全流产率0，不全流产率51．1％，无效48．9％。结论米非司酮配伍米索前列醇治疗稽留流产明显优于传统的己烯雌酚组，值得临床推广应用。     

米非司酮配伍米索前列醇治疗稽留流产

稽留流产是自然流产的一种特殊类型 ,传统治疗方法往往用直接清宫术。我院现用米非司酮配伍米索前列醇治疗 ,并与直接清宫法进行了比较。1　资料与方法1.1　临床资料　 1998年 1月至 2 0 0 0年 8月收治的稽留流产4 1例均符合下列条件 :(1) <4 0周岁 ;(2 )孕周小于 16周 ;(3)宫体小于孕 3月 ;(4)ＤＩＣ筛查试验正常 ;(5 )肝肾功能正常 ;(6 )子宫无明显器质性疾病。随机分为实验组 2 3例 ,对照组18例。1.2　方法　实验组口服米非司酮 5 0ｍｇ ,12ｈ 1次 ,连续给药2ｄ ,第 3天空腹口服米索前列醇 6 0 0 μｇ ,0 .5ｈ后行清宫术[1 ] 。对照组肌…     

米非司酮配伍米索前列醇治疗稽留流产22例疗效分析

目的进一步探讨不同剂量的配伍方法对不同月份、不同类型的稽留流产进行药物流产的疗效.方法对22例不同月份,不同类型的稽留流产患者进行药物流产,妊囊排出后5天复查B超宫腔是否残留,1月后复查B超是否正常.结果完全流产占90.9%,不全流产占4.55%,未流产占4.55%.结论不同剂量的米非司酮配伍米索前列醇用于不同月份、不同类型的稽留流产疗效好;减少或减轻了宫腔手术,患者痛苦小,对机体损伤轻,恢复快.关健词米非司酮;米索前列醇;稽留流产     

米非司酮配伍米索前列醇治疗稽留流产的临床疗效

目的:探讨米非司酮配伍米索前列醇在稽留流产治疗中的的可行性及安全性。方法:将我院2006年1月至2010年12月收治的使用米非司酮配伍米索前列醇治疗的稽留流产患者147例进行回顾性观察总结分析。观察患者服药后的宫缩、阴道流血、妊娠物排出,刮宫难易程度及有无不良反应等情况。结果:流产成功率达93.19%,阴道流血少,手术难度小,时间短,无需二次清宫,术中人流综合征发生率低,患者痛苦少,不良反应轻。结论:米非司酮配伍米索前列醇用于治疗稽留流产安全有效,简便可靠,值得推广。     

米非司酮配伍米索前列醇治疗稽留流产的临床观察

米非司酮配伍米索前列醇治疗稽留流产的临床观察胡茂兰，余艳红，钟梅，金志魁我院于１９９２年１１月至１９９４年６月，应用国产米非司酮配伍米索前列醇（澳大利亚Ｓｅａｒｌｅ药厂产品）治疗稽留流产５８例，取得了满意效果，现报告如下。一、资料与方法１．选择条件：...     

米非司酮配伍米索前列醇治疗稽留流产35例临床观察

随着药物流产广泛使用于终止早早孕和孕10～16周的妊娠,近年来,药物流产在特殊流产领域中也已大量使用。稽留流产是临床上较难处理的一种类型。由于胚胎组织有时可能机化,与子宫壁紧密粘连,造成刮宫术困难,易于子宫穿孔,再次刮宫率也增高。传统上多采用口服大剂量己烯雌酚后行钳刮术,曾有报道口服米非司酮和米索后再行钳刮。我院采用米非司酮配伍米索前列醇治疗稽留流产,使组织物自然排出,取得了满意效果,现分析报告如下。资料与方法一、诊断标准胚胎或胎儿在宫内已死亡尚未自然排出者称稽留流产[1]。二、研究方法1.资料来源　收集我院1997…     

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。     

米非司酮配伍米索前列醇治疗稽留流产30例临床观察

目的 观察米非司酮配伍米索前列醇治疗稽留流产的临床效果。方法 对米非司酮配伍米索前列醇治疗稽留流产30例进行临床观察。结果 完全流产9例（30％），不全流产18例（60％），无效2例（7％），其他1例（3％）。有效率为93％。患者用药后宫颈软化和宫口扩张，使清宫术及钳刮术趋于简单和快捷，减轻了患者痛苦，减少了并发症的发生。结论 采用米非司酮配伍米索前列醇的方法治疗稽留流产效果良好，使部分患者避免了常规的清官术，即使需要清官，也因宫口开大使操作更容易，患者的痛苦明显减轻，故优于既往采用的钳刮术及清宫术。     

米非司酮联合米索前列醇用于稽留流产105例分析

目的：通过用米非司酮联合米索前列醇治疗105例稽留性流产患者结果分析,探讨其临床效果。方法：随机选择2011年12月至2014年6月间的患者105例,在患者同意下开展临床研究,在护理人员监护下患者服用米非司酮：第一日晚八点服用50mg;第二日早八点依旧服用50mg,第二日晚上减少服用量,服用25mg;第三日早上,再次服用25mg米非司酮,护理人员观察确定患者无不良反应后,在一个小时后服用米索前列醇600ug,并持续24小时临床观察。结果：73名患者在2～24小时内组织排出后实行清宫手术,宫扣扩张,8～9号扩宫器顺利通过,清宫十分容易;另外有19名患者在2～24小时内组织未排出,阴道的出血量超过月经量,行清宫手术,宫扣扩张,7．5～8．5号扩宫器能够顺利通过,清宫比较容易;5名患者在24小时后仍有少许流血现象出现,无组织排出,宫口扩张不是十分明显,将米索前列醇400ug放入阴道后穹窿并进行观察,约4小时后,宫颈质地变软,使用6．5～8号宫口扩张器进行清宫顺利;3名患者在服用米非司酮的期间内阴道流血多行清宫术,另外有4名患者出现并发症,进行了第二次清宫手术。结论：米非司酮联合米索前列醇对治疗稽留流产的效果比较安全且有效,值得在该领域进行临床推广应用。     

米非司酮配伍米索前列醇治疗稽留流产32例临床观察

目的 进一步探讨对不同月份、不同类型的稽留流产使用不同剂量的药物配伍方法进行治疗并观察。方法 对32例不同月份、不同类型的稽留流产患者用米非司酮配伍米索前列醇进行药物流产，孕囊排出后5天复查B超观察宫腔是否残留，1个月后复查B超是否正常。结果 完全流产率93．8％。不全流产率3．1％，未流产率3．1％。结论 不同剂量的米非司酮配伍米索前列醇用于不同月份、不同类型的稽留流产疗效好；减少或减轻了宫腔手术，患者痛苦小，对机体损伤轻，恢复快。     

Acceptability and feasibility of medical abortion with mifepristone and misoprostol in Nigeria

Objective

To examine the acceptability and feasibility of medical abortion in Nigeria.

Methods

In total, 250 women who were eligible for legal pregnancy termination with a gestational age of up to 63 days since last menstrual period were enrolled in Benin City and Zaria between May 2005 and October 2006. Participants received 200 mg of oral mifepristone in the clinic and then took 400 μg of oral misoprostol 2 days later—choosing to either return to the clinic or take it at home. Women returned 2 weeks later for an assessment of abortion status.

Results

The vast majority (96.3%) of women had successful complete abortions. Ultrasound was used to determine outcome in less than one-third (28.9%) of participants. Most women (83.2%) took the misoprostol at home. Almost all (96.2%) participants were satisfied or very satisfied with the abortion method.

Conclusion

The introduction of medical abortion with mifepristone and misoprostol could greatly expand current method options and improve the quality of reproductive health care in Nigeria and other settings in which access to legal abortion services is limited.     

Home use of two doses of misoprostol after mifepristone for medical abortion: A pilot study in Sweden and France

Objective To test the feasibility, safety, and efficacy of home use of two doses of misoprostol for medical abortion (MA) in European settings.

Methods One hundred thirty women (100 in Sweden, 30 in France) presenting for first-trimester MA were administered oral mifepristone in the clinic and sent home with two 400 μg doses of misoprostol, along with instructions to take the misoprostol at 24 h intervals. Women were also asked to complete a daily symptom diary. Outcomes of interest included effectiveness, side-effects, and adherence to and acceptability of the home-use regimen.

Results Three women (all in France) were lost to follow-up. Of the remaining 127 women, 124 (98%) had a successful MA. All women adhered successfully to the home-use regimen, and satisfaction with home use was high (98%). Most women experienced noticeable, if transitory, side effects after both the first and second doses of misoprostol (97% and 94%, respectively).

Conclusions Misoprostol may successfully and satisfactorily be used at home as part of a MA regimen in European settings as it has been for years in the US. Further research to determine if two doses of misoprostol are more effective than a single dose would be useful.     

A randomized comparison of mifepristone and self-administered oral or vaginal misoprostol for early abortion

In France, mifepristone in association with orally administered misoprostol is widely used for the early termination of pregnancy (up to 49 days' gestation). In other centers, mifepristone in association with vaginally administered misoprostol has also been used. The aim of the present study was to compare the efficacy and tolerance of mifepristone in association with misoprostol administered orally or vaginally for the termination of pregnancy of up to 49 days' gestation.

A total of 237 women were enrolled in the study. All women received 600 mg mifepristone administered orally and 400 μg misoprostol administered either orally (n = 119) or vaginally (n = 118). A second dose of 400 μg misoprostol was administered if women had not expelled the pregnancy within 3 h. Women were randomized into treatment groups according to the day of their admission.

The overall success rate was 98.7% and there was no significant difference in efficacy between the two groups. There was one treatment failure in the group in which misoprostol was administered orally. Of those women who aborted within 3 h of administration of the first dose of misoprostol, the route of administration of misoprostol did not influence the time to abortion. Of the women who received a second dose of misoprostol, the time to abortion was shorter in those who received misoprostol orally (52 min versus 77 min).

Tolerance was assessed by visual analog scales and was similar for both groups. In both groups, women preferred the oral route of administration.     

米非司酮配伍米索前列醇用于黄体期避孕的研究

目的　探讨在黄体期无保护性生活后 ,使用米非司酮配伍米索前列醇避孕的效果、副反应和对月经的影响。方法　对因多次无保护性生活或无保护性生活结束超过 12 0h要求紧急避孕的69 9例妇女 ,于预期月经来潮前 10d内服用米非司酮 10 0mg ,并于服用米非司酮 48h后加服米索前列醇 40 0 μg。观察是否妊娠和下次月经的情况。 结果　 699例妇女中失访 1例 ,妊娠 2 5例 ,妊娠率 (即失败率 )为 3 6%。妊娠危险性随性生活次数的增多而增加。 673例妇女月经来潮 ,其中 3 81例( 56 6% )在预期月经日± 3d来潮 ,月经提前或延迟超过 7d者分别占 2 2 %和 8 5%。服药后 1周内的主要副反应为腹泻、腹痛 ( 3 1 1% )和恶心、呕吐 ( 2 0 4% )。结论　在黄体期使用米非司酮配伍米索前列醇 ,是一种可选择的避孕补救方法     

Home administration of misoprostol for early medical abortion in India

Objective

To assess the efficacy and acceptability of home administration of misoprostol for early medical abortion in Indian family planning clinics.

Methods

In this prospective cohort study, consenting pregnant women (n = 599) with amenorrhea of 8 weeks or less seeking termination of pregnancy received 200 mg of oral mifepristone followed 48 hours later with 400 µg of oral misoprostol, administered either at home or at the clinic.

Results

Almost all women (88.4%) chose to take misoprostol home. There was no statistical difference in success rates between home and clinic users (89.0% vs 92.4%, Pearson χ² = 0.7; P = 0.395). Most women in both the home (90.7%) and clinic (92.3%) groups were satisfied or very satisfied with the procedure.

Conclusion

Home administration of misoprostol is safe and feasible for introduction into medical abortion services in India.     

米非司酮配伍米索前列醇行药物流产的安全性评价

目的　评价米非司酮配伍米索前列醇行药物流产的安全性。方法　检索国内外 9个医学数据库及 9种中文期刊。采用循证医学的方法对收集有关药物流产安全性研究的文献 ,进行质量评价和数据提取 ;对数据不能合并进行分析时 ,则行定性系统评价。结果　共收集、纳入文献 10 1篇 ,病例 136 4例。其中为药物严重不良反应 115例 ( 8 4 3% ) ,包括药物过敏性和失血性休克、药物中毒性心律失常、抽搐及胎儿畸形等 ;一般不良反应 10 15例 ( 74 4 1% ) ,包括异常出血和轻、中度过敏反应等。系统评价提示 ,药物流产后出血量过多、腹痛、发热和眩晕的发生率比手术流产高 ,相对危险度(RR)及 95 %可信限 (CI)范围分别为 3 2 7,1 14～ 9 38;1 6 3,1 14～ 2 34;1 5 8,1 0 3～ 2 4 4 ;和1 36 ,1 0 6～ 1 75。药物流产后的出血时间比手术流产长 ,加权均数差 (WMD)为 6 4 9,95 %CI为6 0 8～ 7 80。药物流产有并发症者 177例 ( 12 98% ) ,包括滋养细胞疾病、宫腔粘连和继发不孕。为异位妊娠而误用药物流产者 5 7例 ( 4 18% )。结论　药物流产的严重不良反应发生率较低 ,不影响药物流产的临床应用 ,但需要健全监测药物流产不良反应的制度 ;减少药物流产后出血 ,是需要进一步研究的课题     

Medical treatment of missed abortion using misoprostol.

OBJECTIVE: To compare the efficacy of two routes of misoprostol administration (oral and vaginal) for treatment of missed abortion. METHODS: Two hundred women with confirmed missed abortion received 800 mcg misoprostol either orally or vaginally. All women returned for follow-up care 2 days later. If the pregnancy was not completely evacuated at this time, women could wait an additional 5 days or undergo immediate surgical completion. Efficacy was defined as the percent of women discharged from the study without need for surgical intervention. RESULTS: Efficacy was high in both groups and not statistically different (oral=89.0%, vaginal=92.9%). While the groups did not differ in terms of the completion rate by day 2 (oral=41.6%, vaginal=52.7%), the mean time to expulsion was longer (21.04 h) in the oral group than the vaginal group (13.47 h), p=0.041. Women in both groups were highly satisfied with the method. CONCLUSIONS: Medical management of missed abortion with either oral or vaginal misoprostol is highly effective and highly acceptable.     

米非司酮配伍米索前列醇终止生化妊娠及早期临床妊娠的效果比较

目的观察米非司酮配伍米索前列醇终止生化妊娠（无法证实宫腔内或宫腔外妊娠的阶段）的临床效果。方法对月经周期规律、停经≤49d的早孕期妇女,依据停经天数、血清人绒毛膜促性腺激素β亚单位（β-hCG）和阴道B超检查结果分组：生化妊娠（G1）组、早期临床妊娠（G2）组和临床妊娠（G3）组,各500例。给予米非司酮口服,每次25mg,每天2次,连用3d,米索前列醇自口服首片米非司酮72h后,顿服600μg,之后留院观察6h。定期随诊并每日记录观察日志,观察治疗结局并进行满意度自评。结果（1）孕囊排出：G1组妇女123例（24．6％,123／500）见孕囊排出,而G2组、G3组分别有62例（12．4％,62／500）和33例（6．6％,33／500）未见孕囊排出。（2）治疗失败：G1-G3组需手术干预者分别为1例（0．2％,1／500）、20例（4．0％,20／500）和79例（15．8％,79／500）,收住院者分别为5例（1．0％,5／500）、4例（0．8％,4／500）和0。（3）阴道出血：G1～G3组服用米非司酮期间阴道出血者分别为272例（54．4％,272／500）、141（28．2％,141／500）和87例（17．4％,87／500）,3组比较,差异有统计学意义（P〈0．05）;平均阴道出血时间,G1组为（5．8±1．5）d,G：组（9．0±2．9）d,G3组（14．3±5．9）d,3组比较,差异有统计学意义（P〈0．05）。（4）副作用：3组妇女恶心、呕吐、腹痛的发生率高,但程度均较轻;头晕、头痛和腹泻在3组中发生均较少。（5）月经恢复：G1组有97．2％（486／500）的妇女、G2组有90．4％（452／500）的妇女月经能如期复潮,G3组有86．6％（433／500）的妇女月经也能如期复潮。（6）自评满意度：G1组为99．8％（499／500）、G2组97．0％（485／500）、G3组为73．8％（369／500）。结论米非司酮配伍米索前列醇终止生化妊娠是安全、有效的方法,无需等待官腔内临床妊娠被确定后再处理;对终止早期临床妊娠也是较好的方法。