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目的观察米非司酮配伍米索前列醇在胎膜早破引产中的应用效果。方法对我院收治的胎膜早破52例应用米非司酮配伍米索前列醇引产。治疗第1天晨、晚各口服米非司酮75 mg,服药前后2 h禁水、禁食;第2天晨排空膀胱,于阴道后穹隆放置米索前列醇片。孕15~24周者每次放米索前列醇100μg,孕25~33周者每次放50μg,孕34~37周者每次放25μg。根据宫缩情况每4~6 h放药1次,直至出现有规律宫缩为止。结果本组阴道放药当日分娩34例,第2天分娩14例,第3天分娩4例。52例均引产成功,无感染病例,未发现药物不良反应。引产后监测体温、血白细胞、中性粒细胞及C反应蛋白与引产前比较差异无统计学意义(P>0.05)。本组产后出血60~200 ml,胎儿娩出30 min分娩胎盘43例,未娩出胎盘的9例予钳刮术。结论遵循妊娠周数越近晚期米索前列醇用量越小的原则,放药时做好消毒工作,放药后卧床,期间严密观察宫缩及宫口扩张情况,引产前、后酌情使用抗生素,该引产方法安全可行。
Objective To observe the effect of mifepristone and misoprostol in premature rupture of membranes induced by labor. Methods 52 cases of premature rupture of membranes treated with mifepristone and misoprostol were induced in our hospital. Treatment on the first day of morning and evening each mifepristone 75 mg, 2 h before and after administration of water, fasting; the first two days morning emptying the bladder, placed in the vaginal vault dome of misoprostol tablets. Pregnancy 15 ~ 24 weeks each time misoprostol 100μg, pregnancy 25 ~ 33 weeks each put 50μg, 34 to 37 weeks pregnant were placed 25μg. According to contractions every 4 ~ 6 h put the drug 1, until there is a regular contractions so far. Results The group delivered 34 cases of vaginal delivery the same day, the first two days of delivery in 14 cases, the first 3 days of delivery in 4 cases. 52 cases were successfully induced abortion, no cases of infection and found no adverse drug reactions. Post-labor monitoring of body temperature, blood leukocytes, neutrophils and C-reactive protein and induction of labor before the difference was not statistically significant (P> 0.05). The group of postpartum hemorrhage 60 ~ 200 ml, the fetus delivered 43 cases of 30 min delivery placenta, 9 cases of placenta did not give forceps curettage. Conclusions According to the principle of using less amount of misoprostol in the late pregnancy, disinfection should be done when the medicine is put on the medicine and placed in the bed after the medicine is taken. During the period, the contractions of the uterine contractions and the uterine cervix should be closely observed, antibiotics should be used before and after induction, This induction method is safe and feasible.