Induced termination of second trimester pregnancy in women with scarred uterus / 中国医师杂志

ABSTRACT

Objective To investigate the suitable mode of induced termination of pregnancy at second trimester for women with scarred uterus.Methods A retrospective study was performed in 120 cases of second trimester pregnant women with scarred uterus,who requested termination of pregnancy in Department of Obstetrics,Ruijin Hospital of Shanghai Jiaotong University from January 2010 to July 2016.The indications of termination of pregnancy were fetal anomaly,serious pregnant complication,intrauterine fetal deaths and personal factors.The interval time of previous operation to this pregnancy were recorded.It was ＜ 2 years in 35 cases and ≥2 years in 85 cases.The patients with normal hepatic function began to take mifepristone combined with ethacridine lactate (group A,62 cases).The method of mifepristone combined with misoprostol was used in the patients who failed to amniotomy to inject ethacridine lactatebecause of oligohydramnios or small gestational age (group B,58 cases).The detail information of every patient was recorded,including age,gestational weeks,gravidity,parity,the mode of previous operation,previous operation time and indication,the mode of induced labor inthis pregnancy,the interval time from administration to uterine contraction,delivery or not and the interval time from induction to delivery,postpartum hemorrhage,the successful rate of induce labor,and placental retention ratio.Results (1) It had no significant difference between groups A and B in age,gravidity,parity and the interval time of previous operation to this pregnancy (P ＞ 0.05).There was significant difference between two groups in gestational weeks of induction (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 contractionand 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 89.66％.It was significant higher than that of group A (22.58％,P ＜0.01).(3) The rate of retained placenta in group A (19.23％,10/52) was significant lower than group B (4g.7g％,20/41),but the ratio of residual of placenta and membranes in group A (75％,39/52) was significant higher than that of group B (48.78％,20/41).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 and postpartum hemorrhage.It had no significant difference between two groups in incidence of severe pain (P ＞ 0.05).Conclusions Both of methods of mifepristone combined with misoprostol and the mifepristone combined with ethacridine lactate are feasible to induce second trimester termination of pregnancy for women with scarred uterus.