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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
Objective: To understand the effects of low dose mifepristone combined with low dose misoprostol on placental morphology and maternal and infant blood biochemistry during term pregnancy induction. Methods: Forty primiparous women who had no obvious complication and complications during pregnancy were divided into two groups randomly. Group A (20 cases) received oral mifepristone (100 mg) for 36 hours, then misoprostol Ig vaginal fornix after 3h if no contractions and reset; B group 20 patients with misoprostol alone induced labor, the same as above; Group C matched 20 cases of natural labor. 3 groups were taken after maternal blood test placental function; take maternal and umbilical blood after delivery to determine liver and renal function and cortisol; take placenta histological examination and quantitative analysis. Results: The number of misoprostol in group A was significantly lower than that in group B. In the 3 groups, liver and kidney function and placental function were normal. Cortisol increased but there was no significant difference among the three groups. The T-BI in cord blood increased but there was no significant difference among the three groups. Placental villi syncytium nodules, fibrinoid necrosis, the incidence of vascular syncytial cell membrane formation, there was no significant difference between the three groups. CONCLUSION: The failure to find full-term pregnant women with oral mifepristone combined with small doses of misoprostol induction of labor on the morphology and function of placenta did not find maternal and fetal blood biochemical indicators thus changed