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目的:通过临床对中期妊娠不同孕周并边缘性胎盘前置的产妇采取不同的引产方式,旨在探讨出针对中期妊娠并边缘性胎盘前置最佳的引产方式。方法:收集2009年1月-2013年12月在我院接受引产的中期妊娠并边缘性胎盘前置患者20例,根据其妊娠周数不同分成两组进行研究,妊娠13-18周患者10例,妊娠18-28周患者10例,同时再选取60例无边缘性胎盘前置的患者,妊娠周数与人数前两组相同,每组年龄、孕次无显著差异,作为对照组进行效果对比。妊娠13-18周患者均采用米非司酮联合米索前列醇进行引产,妊娠18-28周患者均采用米非司酮联合依沙吖啶引产,通过对患者引产成功率、胎盘残留率、子宫出血量及是否有并发症情况进行统计。结果:妊娠13-18周患者研究组和对照组患者没有接受宫腔纱条填塞,其他各项指标差异不显著;妊娠18-28周患者在引产成功率、胎盘残留率方面无显著差异,但研究组子宫出血量较大,经促宫缩药物宫腔纱条填塞治疗效果显著高于对照组(P<0.05),四组患者均为发生严重感染、子宫破裂等严重并发症。结论:对于中期妊娠边缘性胎盘前置的患者,可以根据妊娠周数不同采用米非司酮联合米索前列醇、利凡诺进行引产,引产的成功率和安全性较高。
OBJECTIVE: To explore different methods of induction of labor in pregnant women with different gestational weeks and marginal placenta previa in mid-term gestation. The aim is to find out the best way to induce labor in mid-term pregnancy with marginal placenta previa. Methods: From January 2009 to December 2013 in our hospital received midwifery induction of pregnant women and marginal placenta previa 20 patients, according to their different gestational age divided into two groups were studied in 13-18 weeks of pregnancy in 10 patients , Pregnancy 18-28 weeks in patients with 10 cases, while re-selection of 60 cases of marginal placenta previa patients, the number of weeks of pregnancy and the same number of the former two groups, each group of age, gestational times no significant difference as a control group to compare the effect . Pregnancy 13-18 weeks of patients with mifepristone combined with misoprostol for induction of labor, 18-28 weeks of pregnancy patients with mifepristone combined with ethacridine induction of labor, the success rate of induction of labor, the rate of residual placenta, Uterine bleeding and whether there are complications statistics. Results: Patients in study group and control group did not receive uterine gauze packing between 13 and 18 weeks of gestation, and other indexes did not differ significantly. There was no significant difference in success rate of induction of labor and placental retention between 18 and 28 weeks of gestation In the study group, there was a large amount of uterine bleeding, which was significantly higher than that of the control group (P <0.05). The four groups of patients had serious complications such as severe infection and uterine rupture. Conclusion: For patients with marginal placenta previa in mid-term pregnancy, mifepristone combined with misoprostol and rivanol may be introduced according to the number of gestational weeks. The success rate and safety of induction of labor are high.