Гинекология (Oct 2016)
Late-induced abortion in cases of congenital fetal malformation incompatible with life
Abstract
Objective: To evaluate the efficacy and safety methods for termination of pregnancy in the late period of congenital fetal malformation incompatible with life. Materials and methods. A randomized comparative study in 2 stages (retrospective and prospective). On stage, I conducted a retrospective analysis of the termination of pregnancy in 150 women who were divided into 2 groups: Group A - 75 women who underwent transvaginal method of transcervical amniocentesis. Under the prospective study (II stage) was 195 pregnant women were divided into 2 groups. The main group - 98 women with the combined method (medical combined with kelp); comparison group - 97 women (WHO scheme). Results. The efficiency of abortion (I stage) by amniocentesis was 93.3%, with prostaglandins - 92%. The effectiveness of the methods used abortion at stage II was 99.0% in the intervention group and 96.9% - in the comparison group. With a decrease in the length of time from the beginning of the method to the induction of late induced abortion in both groups there was a decrease in complications. The greatest number of complications observed in women with a duration of late induced abortion 24 hours or more. Conclusion. The advantages of the combined method has a shorter duration of time from the start of the method prior to uterine activity, due to the mechanical action of kelp on the cervix. A smaller dose of mifepristone (3 times) and a lower dose of misoprostol (2-fold) in the combined process has reduced adverse events (4.2 times).
