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首页> 外文期刊>International Journal of Reproduction, Contraception, Obstetrics and Gynecology >Combination of mifepristone and misopristol in early fetal demise
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Combination of mifepristone and misopristol in early fetal demise

机译：米非司酮和米索前列醇联合用于胎儿早期死亡

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Background: Generally misopristol alone is used in cases of early fetal demise successfully. However to further enhance the success rate a combination of mifepristone along with misopristol can be used. This results in avoiding anesthesia, surgery and operating theater resources, thus being economically viable and results in an overall greater patient satisfaction levels also. Globally, there is a general trend to grant patient greater autonomy in their treatment plan, minimize intervention levels, shorter hospital stay and quicker return to normal schedule and enhanced patient satisfaction levels. Methods: 100 patients with early fetal demise, who reported to a tertiary care service hospital were prospectively evaluated. An oral dose of mifepristone 200 mg stat and 48 hours later misoprostol 800 μg was inserted vaginally. Three hours following the first dose, two further doses of 400 μg misoprostol, was administered vaginally at 3 hours intervals. Repeat medical regime was offered with misoprostol patients who failed to pass products of conception. Success was defined as complete uterine evacuation within 3 days, without the need for surgical evacuation. Results: The overall success rate of medical management was 84%. Mifepristone alone induced natural expulsion of products of conception in (40%) patients complained of heavy bleeding within 48 hours of mifepristone administration alone and in 29 (29%) patients complete miscarriage was confirmed on ultrasound scan. Of the 68 women who were symptomatic at presentation the medical regime failed in 28 (41%), compared with five (16%) failures of the 32 who were asymptomatic. Of the 25 women who had surgical evacuation, eight required an emergency curettage for bleeding. Conclusions: Combination of oral mifepristone along with vaginal misopristol is a simple, safe and effective means of treating early fetal demise, and is an effective alternative method to expectant and surgical options.
机译：背景：通常，仅米索菲特可成功用于早期胎儿死亡。但是，为了进一步提高成功率，可以使用米非司酮和米索非特尔的组合。这导致避免麻醉，手术和手术室资源，因此在经济上可行，并且还导致总体上更高的患者满意度。在全球范围内，普遍存在一种趋势，即给予患者更大的治疗计划自主权，最小化干预水平，缩短住院时间，更快地恢复正常计划并提高患者满意度。方法：前瞻性评估了向三级医疗服务医院报告的100例早期胎儿死亡的患者。口服口服米非司酮200 mg stat，48小时后将米索前列醇800μg插入阴道。第一次给药后三小时，每隔3小时通过阴道再给药两次400μg米索前列醇。米索前列醇未能通过受孕产品的患者可以接受重复治疗。成功的定义是在3天内完全排空子宫，而无需进行手术排空。结果：医疗管理的总体成功率为84％。单独使用米非司酮可自然排泄受孕产物（40％），患者因单独服用米非司酮而在48小时内出现严重出血，而29名（29％）患者经超声扫描证实完全流产。在表现为有症状的68名妇女中，有28名（41％）失败了医疗制度，而在32名无症状的妇女中有5名（16％）失败。在接受手术疏散的25名妇女中，有8名需要紧急刮宫以止血。结论：口服米非司酮联合阴道米索非特尔是一种治疗早期胎儿死亡的简单，安全，有效的方法，是一种有效的替代预期和手术方法的方法。

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