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目的探讨瘢痕子宫中期妊娠引产方法的安全性和有效性。方法回顾性分析天津市静海县医院妇科2006年9月至2011年9月瘢痕子宫中期妊娠要求终止妊娠的孕妇138例,均有一次以上剖宫产史。其中A组为米非司酮+米索前列醇阴道后穹窿放置引产;B组为米非司酮+米索前列醇口服引产。观察子宫下截切口厚度,用药至分娩时间、分娩结局、出血量等。结果两种引产方法在引产成功率、清宫率、软产道裂伤及出血量方面差异无统计学意义(P>0.05);两组用药至分娩时间、软产道裂伤及子宫破裂发生,分别比较,差异有统计学意义(P<0.05)。结论对于瘢痕子宫中期妊娠两种引产方法都是相对安全、有效的。尤其对子宫下截切口厚度>0.4cm者,米索前列醇阴道后穹窿放置术简便、快捷,应作为首选方法。米索前列醇口服对子宫下截切口厚度<0.4cm者更为安全。
Objective To investigate the safety and efficacy of induction of labor during mid-term pregnancy of scar. Methods A retrospective analysis of Tianjin Jinghai County Hospital gynecological September 2006 to September 2011 scar pregnancy expectant termination of pregnancy 138 pregnant women, have more than one history of cesarean section. A group of mifepristone + misoprostol vaginal fornix placed induced labor; B group of mifepristone + misoprostol oral induction of labor. Observe the uterine incision thickness, medication to delivery time, delivery outcome, bleeding and so on. Results There were no significant differences in induction rate of labor, clearance rate, laceration of soft birth canal and bleeding between the two methods (P> 0.05). The time from delivery to delivery, soft birth canal laceration and uterine rupture were compared between the two groups , The difference was statistically significant (P <0.05). Conclusions Both methods for induction of labor during mid-term pregnancy with uterine scar are relatively safe and effective. Especially for uterine incision thickness> 0.4cm, misoprostol vaginal posterior fornix surgery is simple and quick, should be used as the preferred method. Misoprostol orally cut under the uterine incision thickness of <0.4cm were more secure.