高龄产妇中期引产的临床效果

目的:探讨高龄(>35岁)是否增加中期引产的相关风险。方法:收集北京协和医院2013-2019年经依沙吖啶羊膜腔内注射引产的93例患者,以35岁为界,分为低龄组、高龄组,两组根据有无辅助应用欣普贝生分为低龄单药组、低龄双药组、高龄单药组、高龄双药组。均除外内科合并症、瘢痕子宫、哺乳期、多次人工流产史、多次宫腔镜治疗史等高危因素,比较各组引产情况。结果:高龄组与低龄组宫缩发动时间、胎儿娩出时间、总产程时间、产后2h出血量、引产出血率、宫腔残留率、软产道损伤、是否加用宫缩干预、产后感染率、引产成功率均无差异(P>0.05)。但宫颈裂伤均发生在单药组,引产出血均发生在低龄组,宫缩发动和胎儿排出时间双药组均呈缩短趋势。结论:高龄产妇不增加依沙吖啶羊膜腔内注射引产术的风险,经腹依沙吖啶羊膜腔内穿刺术对>35岁孕妇仍是一种安全有效的中期引产方式,依沙吖啶联合欣普贝生引产可能会减少宫颈裂伤的发生。

Observation of the clinical effect of pregnancy termination during the second trimester of pregnancy of women with advanced age

Objective:To explore whether advanced age(over 35 years old)of women increased the risk of pregnancy termination during the second trimester of pregnancy.Method:A retrospective analysis included 93 women who had experienced pregnancy termination during the second trimester of pregnancy by ethacridine lactate amniotic cavity injection in Peking union medical college hospital from 2013 to 2019.All these women had no the risk factors of pregnancy termination,such as medical complications,scar uterus,lactation,history of multiple induced abortions,and history of multiple hysteroscopic treatments.These women were divided into group A(women≤35 years old)and group B(women more than 35 years old).In group A,the women were given dinoprostone suppositories(DS)additionally in group A1 and the women were not given DS additionally in group A2.In group B,the women were given DS additionally were in group B1 and the women were not given DS additionally in group B2.The situations of pregnancy termination during the second trimester of pregnancy of the women were compared among these groups.Results:There were no statistically significant differences in the initiation time of uterine contraction,the fetal delivery time,the total labor time,the volume of 2h postpartum hemorrhage,and the rates of hemorrhage of induced labor,retained products of conception,injury of soft birth canal,additional uterine contraction intervention,postpartum infection,and induced labor success of the women between group A and group B(P>0.05).However,the cervical laceration of the women had occurred in both group A2 and group B2,and the hemorrhage of induced labor of the women had occurred in group B.The initiation time of uterine contraction and the fetal delivery time of the women in both group A1 and B1 had showed a shortening trend.Conclusion:Advanced age(>35 years old)does not increase the risk of the pregnancy termination of women.The ethacridine injection by transabdominal amniocentesis for terminating pregnancy during the second trimester of pregnancy of women with>35 years old was safety and effectiveness,and ethacridine combined with DS for induced labour may reduce the incidence of cervical lacerations.