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Objective:To study the effectiveness and safety of intra-amniotic ethacridine injection in pregnancy induction at ≥28 gestational weeks due to fetal demise.Methods:This retrospective study recruited 77 singleton pregnant women who were admitted to Peking University First Hospital at ≥28 gestational weeks, from January 1, 2011 to December 31, 2021, because of fetal demise diagnosed by ultrasound. Four groups were classified according to different methods of induction, including ethacridine success group ( n=63), ethacridine failure group ( n=4), mifepristone plus misoprostol group ( n=5), and spontaneous delivery group ( n=5). Those in the ethacridine success group were further divided into scarred and non-scarred uterus group. The differences in general conditions and delivery outcomes among these women were analyzed using t-test, one-way analysis of variance, Chi-square test, and Mann-Whitney U test or Kruskal-Wallis H test. Results:(1) Among the 67 patients induced by ethacridine, the success rate was 94.0% (63/67). (2) Compared the ethacridine success group with the mifepristone plus misoprostol group or spontaneous delivery group, respectively, there was no significant difference in total labor duration, intrapartum hemorrhage volume, weight of the dead fetus, and the incidence of postpartum hemorrhage, perineal laceration, and intrauterine residue (all P>0.05). No serious complications such as placental abruption, disseminated intravascular coagulation, intrauterine infection, uterine rupture, conversion to cesarean section, or puerperal infection occurred in the three groups. (3) The duration between ethacridine injection and labor onset was shorter in the ethacridine success group than in the mifepristone plus misoprostol group [(28.5±12.0) h vs (54.2±17.6) h, t=－4.45, P<0.001]. (4) Among the 63 cases of ethacridine success group, the outcomes after induction were similar between scarred and non-scarred uterus group (all P>0.05). (5) The median duration between ethacridine injection and labor onset in the ethacridine success group was 26.8 h (2.3-66.0 h), which meant 95% of the patients went into labor within 51.7 h and 100% within 66 h after the injection. Conclusion:Intra-amniotic injection of ethacridine is safe and effective in termination for singleton pregnancy due to fetal demise at the third trimester and the duration from drug administration to labor onset was significantly shorter than that of mifepristone plus misoprostol, without increasing the risk of any complications.
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Introduction: Mid-trimester termination of pregnancy is one of the most controversial areas of gynaecological practice. It has moral, emotional, social and technical issues. There is continuous need for termination of pregnancy in second trimester, more recently due to increase in the use of antenatal diagnostic procedures. The objective of the present study is to compare acceptability, safety, efficacy, complications and induction-abortion interval of ethacridine lactate with vaginal misoprostol versus vaginal misoprostol alone for mid trimester abortion Materials and methods: This was a comparative study s200 women of 13-20 weeks pregnancy were randomized in two groups. Out of these 100 patients were selected at random for intravaginal misoprostol 400 μg stat followed by 200 μg misoprostol P/V 4th hourly and 100 cases for extra amniotic ethacridine lactate instillation with tablet misoprostol 400 μg Stat followed by tablet misoprostol 200 μg 4th hourly. The relative efficacy, induction- abortion interval, complications of each was studied. Results: The patients studied belong to all categories of marital status, married, and unmarried, widowed. The age ranged from 15-34 years. The gestational age from 14-20 weeks most of them were primi para. Mean induction abortion interval with misoprostol is 15.2 hours while that of emcredil with misoprostol is 16.44 hours. Success rate with misoprostol is 94% while that of emcredil with misoprostol is 95%. Incomplete abortion with misoprostol 2% while that of emcredil with misoprostol 1%. No major complications are noted in both the methods. Yashvardhini Siddareddy, Himabindu Sangabathula. A comparative study of ethacridine lactate with vaginal misoprostol versus vaginal misoprostol alone for mid trimester abortion. IAIM, 2017; 4(6): 38-44. Page 39 Conclusion: Misoprostol is safer, more effective and acceptable than ethacridine for mid trimester termination of pregnancy
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OBJECTIVE:To investigate the effects of uterine arterial embolization combined with Methotrexate and Lactate ethacri-dine on related indexes of mid-pregnant patients with placenta previa abortion. METHODS:The data of 100 mid-pregnant patients with placenta previa who required inducing labor was retrospectively analyzed and divided into observation group(50 cases)and control group(50 cases)by different treatment. Control group received uterine arterial embolization before inducing labor,then received Lac-tate ethacridine injection 100 mg,amniotic injection+Mifepristone tablet 75 mg,and aborted after 2 d. Observation group received uterine arterial embolization after uterine arterial perfusionon both sides,then received Methotrexate for injection 50 mg/side after uter-ine arterial embolization catheter entering uterine artery,Lactate ethacridine injection(the same usage and dosage as control group)+Mifepristone tablet(the same usage and dosage as control group)was given after 12 h. Total parturition,intrapartum hemorrhage,hos-pitalization time,menstruation recovery time,cesarean section,hysterectomy,retained placenta and clearing palace in 2 groups were observed,and postoperative complications were recorded. RESULTS:Intrapartum hemorrhage,hospitalization time,cesarean section rate and hysterectomy rate in observation group were significantly lower than control group,with statistical significance(P0.05). There was no significant difference in the incidence of postoperative complications in 2 groups(P>0.05). CONCLUSIONS:Uterine arterial embolization combined with Methotrexate and Lactate ethacridine can effectively reduce the hemor-rhage of mid-pregnant patients with placenta previa abortion,shorten hospitalization time,and decrease cesarean section and hysterec-tomy rate.
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OBJETCTIVE:To establish a method for the content determination of ethacridine lactate in Compound ethacridine ointment. METHODS:HPLC was performed on the column of Agilent ZORBAX SB-C18 with mobile phase of 0.1% Octanesulfon-ic acid sodium solution-acetonitrile(70∶30,V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 270 nm,the column temperature was 30℃,and the injection volume was 10 μl. RESULTS:The linear range of ethacridine lactate was 10.002-50.010μg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were less than 1%;recovery was 98.96%-100.36%(RSD=0.49%,n=9). CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for content determina-tion of ethacridine lactate in Compound ethacridine ointment.
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Termination of a pregnancy in second and third trimesters involving a dead foetus or one with a lethal anomaly is a challenge for health-care professionals in any setting. In addition to the theoretical concern of the dead foetus inutero causing disseminated intravascular coagulation, continuation of such a pregnancy may not be psychologically and socially acceptable to many women, and both the woman and the caretaker are keen to terminate the pregnancy, preferably without an incision on the uterus. Mid-trimester termination of pregnancy is one of the most controversial areas of gynaecological practice. It has moral, emotional, social and technical issues. There is continuous need for termination of pregnancy in second trimester, more recently due to increase in the use of antenatal diagnostic procedures. Nowadays, majority of mid-trimester abortions are carried out medically. The development of prostaglandin analogues has been a major breakthrough in abortion technology. Natural prostaglandins such as PGE1, PGF2a, PGE2, PG analogues like 15-methyl PGF2a have been used by various routes such as intravenous, intramuscular, intra/extra amniotic, oral and vaginal. Ethacridine lactate works by producing prostaglandin from deciduas, whereas misoprostol being synthetic analogue of misoprostol is supposed to act directly. This study aims to evaluate the effectiveness and safety of the extra-amniotic instillation of ethacridine with vaginal misoprostol in comparison to extra-amniotic instillation of ethacridine lactate with oxytocin IV infusion in terminations of second and third trimester pregnanciesin a tertiary referral hospital catering for both rural and urban population. This study concludes that ethacridine lactate with misoprostol is as efficacious as ethacridineplus oxytocinin termination of second and third trimesters anamolus/IUD foetuses. Though there is no significant difference in efficacy between the two. The ethacridineplus misoprostol is slightly effective in reducing the I-A interval. The efficacy of ethacridine plus misoprostol is slightly higher in early second trimester and ethacridine plus oxytocin is effective in the third trimester.
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OBJECTIVE:To compare the clinical efficacy and safety of Kangshuling gel,mupirocin and lactate ethacridine in the treatment of diabetic foot. METHODS:90 patients with diabetic foot were randomly divided into Kangshuling group,mupiro-cin group and lactate ethacridine group. All the patients were treated by lowing blood glucose,nutritional support,improving micro-circulation and anti-infection,etc. On this basis,3 groups were given Kangshuling gel,Mupirocin ointment and Lactate ethacridine solution for wet compress by gauze. The course was 180 d. The clinic data was observed,including clinical efficacy,and wound ar-ea,healed patients’granulation,epithelial tissue,healing time and incidence of adverse reactions before and after treatment. RE-SULTS:The total effective rate in Kangshuling group was significantly higher than mupirocin group and lactate ethacridine group;healed patients’granulation,epithelial tissue and healing time were significantly shorter than mupirocin group and lactate ethacri-dine group,with significant differences(P0.05). There were no obvi-ous adverse reactions during treatment. CONCLUSIONS:Based on the conventional treatment,Kangshuling gel has better efficacy than mupirocin and lactate ethacridine in the treatment of diabetic foot,with good safety.
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Objective To investigate the efficiency ofKangfuxing liquid, ethacridine lactate in combination with local oxygen therapy for radiation-induced skin damage.Methods A total of 96 patients affected by radiation-induced skin damage were enrolled and randomly allocated to a treatment group and a control group by random number table method, with 48 patients in each group. All patients in the control group were treated with trolamine cream, and those in the treatment group were treated withKangfuxing liquid, ethacridine lactate in combination with local oxygen therapy. Skin dermatitis was scored utilizing Radiation Therapy Oncology Group (RTOG) toxicity scale.Results The total effective rate in the treatment group was significantly higher than that in the control group (97.9%vs.79.1%;χ2=10.119,P=0.002). The distribution of patients with RTOG grades 0 to 4 showed different degrees of improvement, and the number of patients with RTOG 0-4 grades changed from 0, 3, 9, 12, 24 before the treatment to 8, 12, 22, 6, 0 after the treatment in the treatment group, 0, 2, 10, 25, 11 to 2, 5, 18, 23, 0 in the control group. The percent of patients with RTOG grade 0 in the treatment group was significantly increased than that in the control group (16.7%vs. 4.2%;χ2=4.019, P=0.045) and the percent of patients with RTOG grade 3 significantly decreased (12.5%vs.47.9%;χ2=12.649, P<0.001). The percents of patients with dispirited spirit (31.3%vs. 58.3%;χ2=6.066,P=0.014), dry and chapped skin (20.8%vs. 58.3%;χ2=12.588,P=0.000) in the treatment group were all significantly lower than those in the control group.ConclusionKangfuxing Liquid, ethacridine lactate in combination with local oxygen therapy can improve radiation-induced skin damage.
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Objective To investigate the suitable mode of induced termination of pregnancy at second and third trimester for women with scarred uterus. Methods A retrospective study was performed in 90 cases of second and third trimester pregnant women with scarred uterus, who requested termination of pregnancy due to medical indications in Beijing Obstetrics and Gynecology Hospital from September 2002 to June 2009. The indications of termination of pregnancy were fetal anomaly, serious pregnant complication and intrauterine fetal deaths. 72 second trimester pregnant women and 18 third trimester pregnant women were included in this study. The interval time of previous operation to this pregnancy were recorded. And it was <2 years in 20 cases and ≥2 years in 70 cases. The patients with normal Hepatic function began to take mifepristone and had an allergic test of Ethacridine Lactate. The method of mifepristone combined with Ethacridine Lactate were adopted when the allergic test was negative (group A, 54 cases). The method of mifepristone combined with earbeprost methylate suppositories were used in the patients who had a positive reaction to the allergic test of Ethacridine Lactate, or who failed to amniotomy to inject Ethacridine Lactate because of oligohydramnios or small gestational age(group B, 36 cases). Record the detail information of every patient. (1) Age, gestational weeks, gravidity and parity. (2) The mode of previous operation (inducing the scar of uterus), previous operation time and indication. (3) The mode of induced labor in this pregnancy, the interval time from administration to uterine contraction, delivery or not and the interval time from induction to delivery. (4) Postpartum hemorrhage, the successful rate of induce labor, placental retention ratio and rupture of uterus or not. Results (1) It had no significant difference between group A and group B in age, gravidity, parity and the interval time of previous operation to this pregnancy (P> 0.05). But there was significant difference between two groups in gestational weeks of induction(16 weeks vs. 25 weeks,P<0.01). (2) It had no significant difference between two groups in successful rate of induction and postpartum hemorrhage(P>0.05), but the time from induction to regular uterine contraction and delivery in group B was significant shorter than that of group A(P<0.01). The rate of delivery with 24 hours in group B was 94%. It was significant higher than that of group A(13%, P<0.01). (3) The rate of retained placenta in group B (31%, 11/35) was significant higher than group A (10%, 5/52), but the ratio of residual of placenta and membranes in group A was significant higher than that of group B(54% vs. 34% ). It was no significant difference in total rate of postpartum complication between two groups. Further analysis was done in relationship of complication and the time of previous operation. It was no significant difference between the over 2 years group and the less 2 years group in the incidence rate of complications including placental retention, residual of placenta and membranes, rupture of uterus, placental abruption and postpartum hemorrhage. (4) There was 1 case of uterine rupture in group B and 1 case of placental abruption in group A. Conclusions Both of methods of mifepristone combined with carboprost methylate suppositories and the mifepristone combined with Ethacridine lactate are feasible to induced second trimester and late trimester termination of pregnancy for women with scarred uterus. But sufficient preoperation preparation and the course of induction and labor careful monitoring must be done to prevent the uterine rupture.
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Objective To observe oral mifepristone and vaginal misoprostol combination (medical induction labor)for 16-28 weeks termination of pregnancy and compare the effectiveness with intrannmiotic instillation of ethacridine lactate (EL) in this setting. Methods 16-28 weeks gestation, total 100 pregnant women from February 2006 to June 2007 were elected. Two groups were divided randomly: group A (intraamniotic injection of ethacridine lactate)and group B(mifepristone and misoprostol combination). Main outcome measures: success rate, induction-delivery interval, intrapartum hemorrhage, length of stay complications. Results Termination of pregnancy was successful in 38 cases (76%), induction-delivery interval was (42.0±5.8) h, length of stay was (96±6) h and intrapartum hemorrhage was (110.6±6.5) ml in group A. The matched pair analysis revealed termination of pregnancy was successful in 49 cases (98%), there were significantly shorter induction-delivery interval (12.5±4.5) h, length of stay (72±4) h and lower intrapartum hemorrhage (46.3±5.6)ml in group B (P<0.05). Conclusions Compared to intraamniotic instillation of ethacridine lactate, oral mifepristone and vaginal misoprostol combination for 16-28 weeks termination of pregnancy had higher successful rate, shorter induction-delivery interval, length of stay and lower intrapartum hemorrhage.
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0.05).Patients with mucitis of the study group and the control group were 0 and 7.The difference in statistics analysis was significant(P
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OBJECTIVE: To prepare ethacridine lactate solution and to evaluate its quality.METHODS: The solution was prepared with ethacridine lactate as principal components and sterilized by steam sterilization.HPLC method was used for the determination of ethacridine.Calesil ODS column was used with mobile phase consisted of methanol-acetonitrile-0.05% sodium laurysulfonate (pH=3.0,20 ∶ 20 ∶ 60) at detection wavelength of 270 nm.The column temperature was set at 30 ℃ and injection volume was 10 ?L.The effect of sterilization on the content of preparation was determined.RESULTS: The preparation assumed as yellow transparent solution.The linear range of ethacridine was 5～50 ?g?mL-1(r=0.999 9) with an average recovery of 101.47% (RSD=1.32%,n=9).The content of ethacridine in the solution was not changed after sterilization.CONCLUSION: The quality of prepared ethacridine lactate solution is up to the standard.