超声评估药物流产后的子宫内膜  

Ultrasound evaluation of the endometrium after medical termination of pregnancy

作　　者：Cowett A.A. Cohen L.S. Lichtenberg E.S. Stika C.S. 侯巍 

机构地区：[1]Dr.680 North Lake Shore Drive, Chicago, IL 60611, United States

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2005年第8期28-28,共1页Core Journal in Obstetrics/Gynecology

摘　　要：OBJECTIVE: To determine ultrasound parameters associated with the need for clinical intervention after mifepristone and misoprostol termination of pregnancy. METHODS: Charts of patients undergoing medical termination according to a standard protocol in a 13-month period were reviewed. Endometrial thickness and the presence of gestational sac, fluid interface, or complex echoes on post-procedure ultrasonogram were recorded. Repeat doses of medication, surgical intervention, and complications were noted. Success was defined as an abortion completed after a single course of medical therapy. RESULTS: Postprocedure ultrasonograms were available for 525 of 684 patients. Endometrial thickness was measurable in 437 cases. The observed mean endometrial thickness was 4.10 ±1.80 mm (range 0.67-13.4 mm). Endometrial thickness was inversely proportional to the number of days after initiation of therapy when ultrasonography was performed (r =-0.22; P < .001). The endometrium was thicker in the women who had failed than in those who had a successful medical abortion (6.15 ±1.95 mm [range 3.35-10.0 mm] versus 4.01 ±1.75 mm [range 0.67-13.4 mm], respectively; P < .001), but the wide overlap in endometrial thicknesses nullified the clinical usefulness of this difference. CONCLUSION: Endometrial thickness after administration of a single dose of mifepristone and misoprostol for medical termination should not dictate clinical intervention. The decision to treat should be based on the presence of a persistent gestational sac or compelling clinical signs and symptoms.OBJECTIVE: To determine ultrasound parameters associated with the need for clinical intervention after mifepristone and misoprostol termination of pregnancy. METHODS: Charts of patients undergoing medical termination according to a standard protocol in a 13-month period were reviewed. Endometrial thickness and the presence of gestational sac, fluid interface, or complex echoes on post-procedure ultrasonogram were recorded. Repeat doses of medication, surgical intervention, and complications were noted. Success was defined as an abortion completed after a single course of medical therapy. RESULTS: Postprocedure ultrasonograms were available for 525 of 684 patients. Endometrial thickness was measurable in 437 cases. The observed mean endometrial thickness was 4.10 ±1.80 mm (range 0.67-13.4 mm). Endometrial thickness was inversely proportional to the number of days after initiation of therapy when ultrasonography was performed (r =-0.22; P < .001). The endometrium was thicker in the women who had failed than in those who had a successful medical abortion (6.15 ±1.95 mm [range 3.35-10.0 mm] versus 4.01 ±1.75 mm [range 0.67-13.4 mm], respectively; P < .001), but the wide overlap in endometrial thicknesses nullified the clinical usefulness of this difference. CONCLUSION: Endometrial thickness after administration of a single dose of mifepristone and misoprostol for medical termination should not dictate clinical intervention. The decision to treat should be based on the presence of a persistent gestational sac or compelling clinical signs and symptoms.

关 键 词：药物流产 子宫内膜 完全流产 液平面 手术干预 声谱图 药物治疗 临床干预 负相关 临床症状 

分 类 号：R445.1[医药卫生—影像医学与核医学]