在扩张和疏散之前,辅助剂misoprostol或mifepristone用于宫制剂与透扩张器
Stephanie J Lambert1, Britt Lunde1, Lauren Porsch2
1Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Contraception
|January 13, 2024
概括
一夜间的米费普里斯顿是一种安全有效的替代品,可以在扩张和疏散 (D&E) 之前为子宫做准备. 这两种方法都显示出类似的并发症率,而米费普里斯可能会改善临床流程.
科学领域:
- 医学科学 医学科学 医学科学
- 产科和妇科 产科和妇科
- 生殖健康 生殖健康
背景情况:
- 宫准备对于扩张和疏散 (D&E) 程序至关重要.
- 透扩展器是常用的,通常与药物一起用于提高有效性和安全性.
研究的目的:
- 为了比较使用透扩展器的宫制剂的有效性和安全性,在D&E之前与同一天的mizoprostol或一夜间的mifepristone进行比较.
- 评估与每个制备方法相关的手术时间和急性并发症率.
主要方法:
- 在怀孕18至22周之间接受D&E的664名患者的回顾性队列分析.
- 患者接受过夜扩张剂加上口腔mizoprostol (第一期) 或口服mifepristone (第二期).
- 主要结果是手术时间;次要结果包括急性并发症和需要额外的干预措施.
主要成果:
- 在米费普里斯顿组 (9.7分钟) 的平均手术时间略长于mizoprostol组 (7.9分钟),但差异在临床上并不显著.
- 两组之间急性并发症的发生率相似 (4.1%对4.3%).
- 在米费普里斯顿组中,使用额外的米索普罗斯托尔的比例更高,但使用额外的扩展剂没有差异.
结论:
- 过夜的米费普里斯顿是一种安全有效的替代品,可以在D&E之前为子宫做准备.
- 观察到的手术时间差异在临床上没有意义.
- 在临床工作流程和患者体验方面,米费普里斯可能会带来优势.
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