足月妊娠米索引产孕妇IL-8的表达与临床意义

目的通过检测米索前列醇引产孕妇引产前和引产后3h及产程不同阶段血浆白细胞介素8(Interleukin-8 IL-8)的表达,探讨IL-8水平的变化规律、与宫颈分泌物胎儿纤维结合素(fetal fibronectin FFN)的相关性及其临床意义。方法选择妊娠≥40w住院待产孕妇60例作为研究对象,引产前检测FFN与宫颈Bishop评分,FFN阴性/Bishop<7分20例为Ⅰ组,FFN阳性Bishop<7分40例为Ⅱ组,应用酶联免疫吸附法(ELISA)监测引产前和引产后不同阶段IL-8水平,分析引产孕妇IL-8水平的变化规律,比较二组IL-8水平的差异,观察IL-8水平、FFN阳性、引产效果三者之间的相关性。结果IL-8水平与FFN阳性呈显著正相关,并随着产程的进展升高,IL-8水平和FFN阳性均与引产效果有密切关联。结论IL-8水平反映了妊娠晚期子宫下段的生理变化,可以做为独立于宫颈Bishop评分及超声检测以外预测分娩启动的生化指标之一。     

米索前列醇预防产后子宫复旧不良的临床观察

目的观察舌下含服米索前列醇预防产后子宫复旧不良的效果。方法高危子宫复旧不良产妇240例,随机分为观察组和对照组,观察产后舌下含服米索前列醇200μg/12h,连用5d。对照组采用分娩后肌内注射缩宫素20U,口服益母草冲剂15g/8h,服用1周。结果观察组的子宫复旧明显好于对照组,并且产后出血量少,复旧时间短。结论米索前列醇舌下含预防产后子宫复旧不良效果显著,用药方便,易吸收,价格低廉,值得临床推广应用。     

米非司酮合并米索前列醇房事后避孕临床多中心研究

在黄体早、中、晚期应用米非司酮合并米索前列醇与单用米非司酮进行房事后避孕临床多中心比较性研究。５４１名自愿接随机序号参加本研究的健康、月经规律妇女，组Ⅰ口服米非司酮２５ｍｇ，ｑ１２ｈ共４次，第三天上午加服米索前列醇０．４ｍｇ，妊娠率为０．４％。组Ⅱ单服米非司酮２５ｍｇ，ｑ１２ｈ，共４～６次，妊娠率为３％。二者差异有显著性（Ｐ＜０．０５）。两者引起出血类型和时间均与正常月经相似，且无明显副反应发生，错过了服用传统房事后避孕药时，采用本研究的方法可不考虑性生活时间、次数。这种方法提供了一种新型有效避孕方法。     

Mifepristone-misoprostol abortion: a trial in rural and urban Maharashtra,India

As several important policy questions remain regarding the use of medical abortion in developing countries, we investigated the safety, efficacy, and acceptability of mifepristone-misoprostol abortion in the outpatient family planning departments of two urban hospitals and one rural hospital in India. Nine-hundred women (with gestations of < or =63 days in the urban sites and < or =56 days in the rural site) received 600 mg mifepristone followed 48 h later by 400 microg oral misoprostol in the clinic. Four point four percent or fewer urban women and 1.0% rural women were lost to follow-up. Perfect and typical-use failure rates were low at all sites. While rural women reported fewer side effects at all sites, the vast majority of women were satisfied with their medical abortions. Medical abortion can be offered safely, effectively, and acceptably in the outpatient family planning departments of urban and rural hospitals in India.     

药物流产终止10～14周妊娠的临床观察

目的 观察米非司酮配伍米索前列醇用于终止10～14w．妇女的临床疗效。方法对妊娠10—14w要求终止妊娠而无禁忌症的孕妇140例，给予米非司酮配伍米索前列醇流产。结果米非司酮配伍米索前列醇用于终止10～14w妊娠妇女140例中，有效137例，有效率97．8％，失败3例。结论米非司酮配伍米索前列醇流产是一种安全简便、成功率高、痛苦轻的有效方法。     

Oral misoprostol versus intracervical dinoprostone for induction of labor.

OBJECTIVES: To compare oral misoprostol with dinoprostone for induction of labor and their effects on the fetal heart rate patterns. METHODS: In a randomized controlled trial, 200 patients received either misoprostol 50 mug orally for every 4 h, or dinoprostone 0.5 mg intracervically for every 6 h. Cardiotocographic recordings, in 10-min windows 30, 60, and 80 min after prostaglandin administration during induction and continuously during labor, were compared between the two groups. Primary outcome for effectiveness and safety was assessed in terms of the number of vaginal deliveries within 24 h and fetal heart rate abnormalities during induction and labor respectively. RESULTS: Data from 96 patients in the misoprostol group and 95 in the dinoprostone group were analyzed. There were no significant differences in respect of the number of vaginal deliveries within 24 h (RR 1.12; 95% CI 0.88-1.42). The frequency of suspicious and pathological fetal heart rate patterns did not differ significantly but significantly more cardiotocographs in the dinoprostone group had non-reassuring baseline variability 60 min after dose administration (RR 0.33; 95% CI 0.14-0.77). Maternal and neonatal outcomes did not differ significantly. CONCLUSION: Oral misoprostol is as effective as intracervical dinoprostone for induction of labor with no difference in the frequency of fetal heart rate abnormalities.     

舌下含服米索前列醇配伍米非司酮终止中期妊娠的临床研究

【目的】比较舌下含服与阴道后穹隆放药米索前列醇配伍米非司酮在中期妊娠流产中的效果。【方法】16～24w中期妊娠妇女随机分为舌下组、阴道组，经米非司酮150mg预治疗48h，分别给予米索前列醇200μg舌下含服、阴道后穹隆放药，3h重复1次，直到有规律宫缩。主要的观察指标是引流时间、24h内分娩率、完全流产率、阴道流血量、药物的不良反应。【结果】舌下组比阴道组引流时间明显缩短，24h内分娩率、完全流产率、阴道流血量、药物不良反应两组间均无明显差异。【结论】舌下含服米索前列醇能缩短引流时间，使用方便，更易被患接受。     

米索前列醇、利多卡因和仕泰栓在人流术中镇痛效果的临床分析

目的总结分析米索前列醇、利多卡因和仕泰栓3种药物用于人工流产手术中的临床镇痛效果。方法选择自愿终止妊娠的早孕妇女597例,术前随机分为3组:A组口服米索前列醇片;B组宫颈旁注射利多卡因;C组肛门塞仕泰栓。结果A、B、C3组的无痛率分别为91.9%,93.4%和89.2%;宫颈松弛率分别为90.7%、83.5%和85.8%;出血量>30ml者分别为4.7%、7.4%和5.1%;人流综合征发生率分别为2.3%、2.6%和2.8%。结论3种药物用于人工流产术中的镇痛效果明显,宫颈松弛情况良好,出血量较少,人流综合征发生率较低,受术者易于接受。     

米索前列醇伍利多卡因在人工流产术中的镇痛作用

目的探讨术前口服米索前列醇与宫腔注射利多卡因在人工流产术中的镇痛效果.方法实验组与对照组各150例,两组年龄、孕周、孕次经统计学检验有可比性(P＞0.05).实验组在人工流产术前3 h口服米索前列醇600μg,于术前5 min用特制的宫腔注药导管宫腔内注入利多卡因5 ml;对照组150例不用任何药物,常规行人工流产.结果两组扩张宫颈时疼痛及吸宫时疼痛程度相比差异非常显著(P＜0.01).实验组术中宫颈明显扩张(P＜0.01);平均手术时间缩短(P＜0.01);人工流产综合征发生率明显降低(P＜0.01);不增加术中出血量(P＞0.05).结论口服米索前列醇伍宫腔注射利多卡因能明显减轻人工流产术中的痛苦,且药物不良反应轻微.