Analysis of the outcome of labor induction by ethacridine combined with mifepristone in women of different gestational weeks
Objective To study the outcome of labor induction by ethacridine combined with mifepristone in women of different gestational weeks.Methods Clinical data of 2043 cases of labor induction by ethacridine combined with mifepristone were collected,of which 2027 cases were successfully induced and 16 cases failed.Women with successfully induced labor were divided into three groups according to different gestational weeks,of which 192 cases in Group A had gestational weeks of 14-16+6 weeks,1634 cases in Group B had gestational weeks of 17-27+6 weeks,and 201 cases in Group C had gestational weeks of≥28 weeks.The clinical features and the related factors of postpartum hemorrhage in women with successful labor induction were compared among the three groups,and the basic information of 16 cases of failed labor induction by ethacridine combined with mifepristone was analyzed.Results Comparison of maternal age,height,gravidity,scarred uterus,combined uterine fibroids,twin pregnancies,postpartum hemorrhage,and retained placenta among the three groups showed no statistically significant differences(P>0.05).Comparison of maternal weight,body mass index(BMI),parity,intra-partum hemorrhage,time from induction to delivery,time from induction to delivery,placenta praevia,diabetes mellitus,hypertension,thyroid disorders,fetal abnormality,stillbirth/missed abortion,retained placenta,perineal laceration,and postpartum anemia among the three groups showed statistically significant differences(P<0.05).The weight and BMI in group B and group C were higher than those in group A,and group C was higher than group B(P<0.05);group B and group C had fewer deliveries than group A,and shorter time from labor induction to delivery than group A(P<0.05);group C had more hemorrhage during labor than group B and group A;the differences were statistically significant(P<0.05).The incidence of scarred uterus was 7.69%in group A,26.15%in group B and 50.00%in group C.The incidence of perineal laceration was 0 in group A,6.15%in group B and 50.00%in group C.Comparing the incidence of maternal scarred uterus and perineal laceration in the three groups,the difference was statistically significant(P<0.05).Comparison of the incidence of placenta previa,retained placenta,fetal abnormality,stillbirth/missed abortion,and postpartum anemia among the three groups showed no statistically significant difference(P>0.05).There were 16 cases of failed labor induction,including 8 cases at 14-16+6 weeks:1 case was found to have placental penetration after secondary ethacridine induction,the remaining 7 cases were successfully induced by drug induction or forcep curettage.In 5 cases at 17-27+6 weeks of gestation,3 cases were successfully induced by forcep curettage,2 case converted to cesarean section due to obstructive dystocia and antepartum hemorrhage.3 cases at≥28 weeks of gestation,all of whom underwent cesarean section:1 case with preeclampsia,1 case with obstructed obstructed labor,and 1 case with giant fibroids.Failed mothers were terminated by drug induction,forceps,or cesarean section.Conclusion Intraamniotic injection of ethacridine combined with mifepristone is safe and effective for labor induction.This method is also suitable for mid-term gestation at less than 17 weeks.Postpartum hemorrhage increased with increasing gestational weeks,but the overall rate of postpartum hemorrhage tended to be consistent.The time required for successful labor induction in women at 14-16+6 weeks of gestation is relatively long,but within an acceptable range.
万方数据
维普
