早期妊娠失败药物流产效果的影响因素分析

目的 探讨孕囊大小等因素对早期妊娠失败行药物流产成功率的预测价值.方法 对被诊断为稽留流产和空囊妊娠的患者81例入院后行阴道B超检查,测量胎儿头臀长或孕囊大小,记录已测过的血β-人绒毛膜促性腺激素（β-hCG）水平,将800 μg米索前列醇阴道置药12 ～24 h行阴道B超检查,如果孕囊完整或前后宫腔内膜厚度超过30 mm,再给相同剂量的药物或行清宫术.结果 药物治疗成功32例（39.51％）,为A组;49例（60.49％）药物流产失败行清官术,为B组.两组在年龄、孕周、孕囊大小、流产次数方面无显著差异,而妊娠次数、分娩次数和血β-hCG水平两组有显著差异（P＜0.05）.结论 孕囊大小不作为早期妊娠失败药物流产成功的预测因素,而妊娠、分娩次数及血B-hCG水平会影响药物流产的成功率.

Influencing Factors of Drug Abortion Effect for Early Pregnancy Failure

Objective To explore the prediction value of the factors such as the gestational sac size on the success rate of drug abortion for early pregnancy failure.Methods Eighty-one patients with missed abortion and anembryonic pregnancy were measured the crown-rump length and the gestational sac size by using transvaginal ultrasound（TVU） after hospitalization.The detected beta-human chorionic gonadotropin（β-hCG） level was recorded.Misoprostol 800 μg was intravaginally administrated.Then TUV was performed at 12-24 h after vaginal administration.If the gestational sac was still intact or the anterior and posterior endometrial thickness exceeded 30 mm,the same dose of misoprostol was given or the uterine curettage was performed.Results Thirty-two cases （39.51％） were successful in the medical treatment as the group A and 49 cases （60.49％） were performed the uterine curettage due to the failure of drug abortion as the group B.Between the two groups,there the age,gestational weeks,gestational sac size and abortion times had no statistical differences,but the pregnancy times,delivery times and blood β-hCG level had statistical differences（P ＜ 0.05）.Conclusion The gestational sac size is not a predict factor of successful drug abortion for early pregnancy failure.But the pregnancy times,delivery times and and blood β-hCG level affect the success rate of drug abortion.