不同孕周产妇采用依沙吖啶配伍米非司酮引产的分娩结局分析  

Analysis of the outcome of labor induction by ethacridine combined with mifepristone in women of different gestational weeks

作　　者：钱宇佳[1] 祁晓萱 王文婷[1] 王鑫宇 程青[1] QIAN Yu-jia;QI Xiao-xuan;WANG Wen-ting(Department of Family Planning,Women's Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Nanjing 210000,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)计划生育科,210000

出　　处：《中国实用医药》2024年第20期118-122,共5页China Practical Medicine

摘　　要：目的研究不同孕周产妇采用依沙吖啶配伍米非司酮引产的分娩结局。方法收集2043例羊膜腔内依沙吖啶配伍米非司酮引产产妇的临床资料,其中成功引产2027例,引产失败16例。按孕周不同将引产成功的产妇分为三组,其中A组192例产妇孕周为14~16^(+)6周,B组1634例产妇孕周为17~27^(+)6周,C组201例产妇孕周为≥28周。比较三组产妇的临床特征、成功引产产妇产后出血的相关因素,并分析16例依沙吖啶配伍米非司酮引产失败产妇的基本信息。结果三组产妇年龄、身高、孕次、瘢痕子宫、合并子宫肌瘤、双胎妊娠、产后出血、胎盘滞留比较,差异无统计学意义(P>0.05)。三组产妇体重、体质量指数(BMI)、产次、产时出血量、引产至分娩时间、引产至分娩时间、前置胎盘、糖尿病、高血压、甲状腺疾病、胎儿发育异常、死胎/稽留流产、胎盘胎膜残留、会阴裂伤、产后贫血比较,差异有统计学意义(P<0.05)。B组和C组的体重、BMI高于A组,C组高于B组(P<0.05);B组和C组的产次少于A组,引产至分娩时间短于A组(P<0.05);C组的产时出血量多于B组和A组,差异均有统计学意义(P<0.05)。A组产妇瘢痕子宫发生率为7.69%,B组为26.15%,C组为50.00%;A组会阴裂伤发生率为0,B组为6.15%,C组为50.00%。三组产妇瘢痕子宫、会阴裂伤发生率比较,差异有统计学意义(P<0.05),三组产妇前置胎盘、胎盘胎膜残留、胎儿发育异常、死胎/稽留流产、产后贫血发生率比较,差异无统计学意义(P>0.05)。16例产妇引产失败,其中14~16^(+)6周8例:1例二次依沙吖啶引产术失败后剖宫取胎,术中发现胎盘植入穿透型;其余7例均通过药物引产或钳刮手术顺利引产。17~27^(+)6周5例,3例通过钳刮术顺利引产,1例因梗阻性难产,1例因产前出血剖宫取胎。≥28周3例,均行剖宫取胎术:1例先兆子宫破裂,1例梗阻性难产,1例巨大子宫肌瘤。失败产妇通过药物引产Objective To study the outcome of labor induction by ethacridine combined with mifepristone in women of different gestational weeks.Methods Clinical data of 2043 cases of labor induction by ethacridine combined with mifepristone were collected,of which 2027 cases were successfully induced and 16 cases failed.Women with successfully induced labor were divided into three groups according to different gestational weeks,of which 192 cases in Group A had gestational weeks of 14-16^(+)6 weeks,1634 cases in Group B had gestational weeks of 17-27^(+)6 weeks,and 201 cases in Group C had gestational weeks of≥28 weeks.The clinical features and the related factors of postpartum hemorrhage in women with successful labor induction were compared among the three groups,and the basic information of 16 cases of failed labor induction by ethacridine combined with mifepristone was analyzed.Results Comparison of maternal age,height,gravidity,scarred uterus,combined uterine fibroids,twin pregnancies,postpartum hemorrhage,and retained placenta among the three groups showed no statistically significant differences(P>0.05).Comparison of maternal weight,body mass index(BMI),parity,intra-partum hemorrhage,time from induction to delivery,time from induction to delivery,placenta praevia,diabetes mellitus,hypertension,thyroid disorders,fetal abnormality,stillbirth/missed abortion,retained placenta,perineal laceration,and postpartum anemia among the three groups showed statistically significant differences(P<0.05).The weight and BMI in group B and group C were higher than those in group A,and group C was higher than group B(P<0.05);group B and group C had fewer deliveries than group A,and shorter time from labor induction to delivery than group A(P<0.05);group C had more hemorrhage during labor than group B and group A;the differences were statistically significant(P<0.05).The incidence of scarred uterus was 7.69%in group A,26.15%in group B and 50.00%in group C.The incidence of perineal laceration was 0 in group A,6.15%in group B and 50.00%i

关 键 词：依沙吖啶 引产 分娩结局 米非司酮 

分 类 号：R719.3[医药卫生—妇产科学]