米非司酮配伍米索前列醇足月妊娠引产对胎盘及母婴血生化的影响

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、功能及母婴血生化的变化。方法 :将 80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两组 ,A组 36例 ,口服米非司酮 10 0mg ,36h后将米索前列醇 50 μg置于阴道后穹窿 ,间隔 3h如无宫缩再置 ,2 4h内使用米索前列醇不超过 3次 ;B组4 4例单用米索前列醇引产 ,用法同上 ;C组配对 4 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 ;取胎盘行形态学检查并进行定量分析。结果 :A组需用米索前列醇的次数较B组明显减少。 3组产妇肝、肾功能及胎盘功能均正常 ,皮质醇组间无明显差异 ,脐血T -BI增高但组间无明显差异。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

Effect of lador induction with mifepristone and misoprostol on structure and maternal - fetal biochemical result.

Objective:To study the effect of small amount mifepristone on placental structure and biochemical changes of mothers and fetus in labor induction of full-term pregnancy.Methods:80 cases with indication of induced labor for preventing from postterm pregnancy,were assigned to 2 groups randomly.36 cases in group A were treated with mifepristone 100mg,po,36 hours later,with misoprostol 50 μg,q3h,pv.The other 44 cases in group B were only treated with misoprostol 50μg,q3h,pv.Besides,40 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,C.The placental structure was examined under microscopy and by morphometriological feature image analysis.Results:No significant changes were observed in the biochemical tests and placental structure among three groups. Conclusions:Labor induction of full-term pregnancy with mifepristone 100mg and small amount of misoprostol seems a safe,effective method.