Clinical Overview Of Intra-amniotic Injection Of Ethacridine Lactate In Combination With Mifepristone For Second-trimester Termination Of Pregnancies In The Scarred Uterus

Background:The risks and adverse reaction incidences for second-trimester termination of pregnancies(TOP) in the scarred uterus are very high, but there are no unified guidelines and there are many ways to be used for it. Therefore, to search an safety、efficacy and quick method for second-trimester termination of pregnancies in the scarred uterus is an urgent matter to be resolved for obstetrics and gynecology.Objectives:To evaluate the clinical safety and efficacy of intra-amniotic injection of ethacridine lactate in combination with mifepristone for second-trimester Termination of Pregnancies in the scarred uterus.Methods:Review104women who undergoing the induction of a second-trimester TOP in the scarred uterus from January,1995to January,2005in Women’s Hospital,School of Medicine,Zhejiang university, A total of54pregnant women were assigned to group A(intra-amniotic injection of ethacridine lactate and oral mifepristone),and50pregnant women were assigned to group B(only intra-amniotic injection of ethacridine lactate).To compare the two groups in the following aspects:the time from using ethacridine lactate to appear contraction and delivery,the success rate of induced abortion,the rate of retained placental tissue,bleeding, complication and so on.Results:1.There are no statistical difference in mean age, gestational age, gravidity, parity, and time from previous operation between the two group;2.The median medication to contractions interval for group A and B was respectively25.16h and37.25h,the median medication to delivery interval was respectively38.68h and50.29h,there was no significant difference in the two group(P>0.05);3.The success rate of induced abortion was96.0%in group A and94.0%in group B, the success rate of group A was greater than that of group B;4.For group A, there was13retained placental tissue, the rate of retained placental tissue was24.1%,and there was33retained placental tissue for group B, the rate of retained placental tissue was66.0%, there are significant difference in the two group(P<0.05);the rate of cervical laceration for group A was5.5%, for group B it was12.0%;For group A, there were3complications, the rate of complication was5.6%, for group B, there were5complications, the rate of complication was10.0%,the incidence of cervical laceration complication of group A was significantly lower than that of group B, there was significantly statistical difference;5.The median volume of bleeding in group A was126.67ml and182.00ml in group B, there was also significant difference in the two group(P<0.05).Conclusions:There is definitely clinical curative effect for second-trimester TOP in the scarred uterus using intra-amniotic injection of ethacridine lactate in combination with mifepristone,it has high success rate and less complication,and the method is also very easy and safety, thus it should be widely applied.