【摘要】 目的:探讨剖宫产6个月内再次妊娠终止的安全有效方法。方法:对我院412例剖宫产6个月内再次妊娠的住院女性终止妊娠方法进行临床分析。结果:选择在B超下负压吸宫术与药物流产两种方法终止≤10周的宫内妊娠,出血分别为9．56±5．28ml和14．65±15．02ml,P<0．05,负压吸宫术前行宫颈准备与不准备两组术时出血分别为:8．47±3．72ml和12．0±8．22ml。药物流产清宫率妊娠≤10周和>10周分别为85．7％和96．2％(平均87．2％)。利凡诺引产前行宫颈准备与未行宫颈准备两组出血量无明显差异,但引产时间明显缩短,分别为35．06±5．38h和41．37±13．07h。结论:终止剖宫产6个月内再次妊娠,孕早期可采用药物流产或B超监测下行吸宫术,术前以米索药物宫颈准备,出血少,安全性高。若终止10-16周的妊娠,可选择药物流产,但清宫率较高。孕期超过16周以利凡诺引产宜作宫颈准备。更多还原

【Abstract】 Objective: To explore the safe and effective methods to terminate pregnancy in 6 months after cesarean section. Methods: A clinical analysis about pregnancy termination methods was conducted for 412 inpa-tient women with pregnancy after recent cesarean section. Results: Two methods could be chosen to terminate pregnancy less than 10 gestational weeks: either suction curettage under the ultrasound (average blood loss: 9.56±5.28 ml) or medical abortion (average blood loss 14.65±15.02 ml). There was significant difference between two methods. Compared the suction curettage under two conditions (either with cervix preparation or without cervix preparation), blood losses of two conditions were 8.47±3.72 ml and 12.0±8.22 ml, respectively. The rates of dilatation and curettage after medical abortion were 85.7% (for those less than 10 weeks), and 96.2% (for those more than 10 weeks), respectively (average 87.2%). There was no difference observed in blood loss between two status of induced abortion with Rivanol: with or without cervix preparation, but the duration of induced abortion with cervix preparation was obviously shorter (35.06±5.38 h, compared with those without preparation 41.37±13.07 h respectively). Conclusion: Suction curettage under the ultrasound is the better way to terminate early pregnancy in 6 months after cesarean section. It is suggested that before induced abortion, administration of misoprostol to prepare the cervix (the cervical dilatation), which could decrease blood loss and make abortion safer. Medical abortion is chosen for pregnancy (≤10 weeks) with dilatation and curettage. Induced abortion with Rivanol is still mainly choice for intermediate pregnancy (>16 weeks).更多还原