米非司酮和米索前列醇在一家社区医院治疗早孕流产中的成功案例:前瞻性研究。

IF 2 Q2 OBSTETRICS & GYNECOLOGY
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引用次数: 0

摘要

背景:这是一项前瞻性单臂研究,旨在了解早孕流产(EPL)治疗中孕囊的排出率:这项前瞻性单臂研究旨在了解早孕流产(EPL)治疗中孕囊的排出率:我们招募了 441 名参与者,其中 188 名符合资格标准。方法:我们招募了 441 名参与者,其中 188 名符合资格标准,参与者年龄在 18 岁及以上,经历过确诊的早期妊娠流产(结果:181 名参与者按照方案进行了治疗,188 名参与者的妊娠囊被排出:181名参与者按照方案进行了治疗,169名(93.3%)参与者在第二次就诊(第14天)时妊娠囊完全排出。尽管孕囊已排出,但在随后的随访中,有 29 例(17.1%)患者根据子宫内膜增厚的超声评估被诊断为受孕产物滞留:结论:在使用米非司酮进行预处理后,再使用两剂米索前列醇,并进行为期 14 天的随访,胎囊排出率很高,是一种安全的 EPL 处理方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Success of Mifepristone and Misoprostol in the Management of Early Pregnancy Loss at a Community Hospital: A Prospective Study

Objectives

This prospective single-arm study was conducted to understand the expulsion rate of the gestational sac in the management of early pregnancy loss (EPL).

Methods

We recruited 441 participants; 188 met the eligibility criteria. Participants were 18 years of age and older who experienced a confirmed EPL (<12 weeks gestational age) defined by an intrauterine pregnancy with a non-viable embryonic or anembryonic gestational sac with no fetal heart activity. Participants were given 200 mg of mifepristone pre-treatment orally followed by 2 doses of misoprostol 800 μg vaginally after 24 and 48 hours. Participants were seen in follow-up on day 14 to confirm the absence of a gestational sac, classified as treatment success. For failed treatment (defined by retained gestational sac), we offered expectant management or a third dose of misoprostol and/or dilatation and curettage. We followed all participants for 30 days. We collected data on overtreatment for retained products of conception and hospital admissions for adverse events.

Results

Overall, 181 participants followed the protocol and 169 (93.3%) participants had a complete expulsion of the gestational sac by the second visit (day 14). Twelve (6.6%) failed the treatment and 1 had an adverse event of heavy vaginal bleeding requiring dilatation and curettage. Despite the expulsion of the gestational sac, 29 cases (17.1%) at subsequent follow-up were diagnosed as retained products of conception based on ultrasound assessment of thickened endometrium.

Conclusions

Pretreatment with mifepristone followed by 2 doses of misoprostol with a 14-day follow-up resulted in a high expulsion rate and is a safe management option for EPL.

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来源期刊
CiteScore
3.30
自引率
5.60%
发文量
302
审稿时长
32 days
期刊介绍: Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.
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