米非司酮用于足月妊娠引产胎盘组织学及母婴血液生化变化的观察

目的 :了解小剂量米非司酮配伍小剂量米索前列醇用于足月妊娠引产时胎盘形态及母婴血液生化的变化。方法 :对 40例妊娠期无明显并发症及合并症 ,因孕期延长而引产的初产妇随机分成 2组 ,甲组 2 0例 ,口服米非司酮 10 0mg ,36h后米索前列醇 5 0 μg置阴道后穹隆 ,3h后如无宫缩再置 ;乙组 2 0例单用米索前列醇引产 ,用法同上 ;丙组配对 2 0例自然临产者。3组临产后均取母血检测胎盘功能 ;分娩后取母血及脐血测定肝、肾功能及皮质醇 ;取胎盘进行组织学检查并进行定量分析。结果 :甲组需用米索前列醇的次数较乙组明显减少。 3组母血肝、肾功能及胎盘功能均正常 ,皮质醇增高但 3组间无明显差异 ,脐血T -BI增高但 3组间无明显差异。胎盘绒毛合体细胞结节、纤维素样坏死、血管合体细胞膜形成的发生率 ,3组间无明显差异。结论 :未能发现足月孕妇口服米非司酮 10 0mg配伍小剂量米索前列醇引产对胎盘形态及功能产生影响 ,亦未发现母婴血生化指标因此而改变

THE EFFECTS OF MIFEPRISTONE ON PLACENTAL STRUCTURES AND BIOCHEMICAL CHANGES PREGNANT WOMEN AND FETUS IN INDUCED LABOR OF FULL-TERM PREGNANCY

Objective:To study the effects of small doses of mifepristone with misoprosto on placental structures and biochemical changes of pregnant women and fetus in induced labor of full-term pregnancy. Methods:40 full-term pregnant women, with indication of induced labor for preventing prolonged pregnancy, were assigned to 2 groups randomly. 20 cases in group A were treated with mifepristone 100mg,po,36 hours latter, with misoprostol 50μg,q3h,pv.The other 20 cases in group B were treated only misoprostol 50μg,q3h,pv.Besides,20 cases without using above drugs were consisted of control group(group C).Placental function,liver function,nephritic function and glucocorticoids were tested in group A,B and C.The placental structures were examined by microscopy and morphome triological feature image analysis.Results:No significant changes were observed in the biochemical tests and placental structures among three groups.Conclusions:It was safe in labor induction according to the result of placental structural examination and blood tests that full-term pregnant women took mifepristone 100mg with small doses of misoprostol.