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| Effect of uterine artery embolization combined with ethacridine and mifepristone used for termination of the second trimester of pregnancy in the women with placenta previa |
1.West China Guang'an Hospital of Sichuan University (Guang'an People's Hospital), Sichuan Province, 638000;
2. The Second Affiliated Hospital of Chengdu Medical College, 416 Hospital of Nuclear Industry, Chengdu, Sichuan Province |
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Abstract To analyze the effects of uterine artery embolization (UA) combined with ethacridine and mifepristone used for induced labor of pregnant women with placenta previa during the second trimester of pregnancy on their prognosis. Methods: The clinical data of pregnant women with scarred uterus and placenta previa during the second trimester of pregnancy who had been induced labor from January 2017 to January 2022 were analyzed retrospectively. Based on the matching by the general data, these women were divided 70 cases with ethacridine combined with mifepristone for induced labor in control group and 70 cases with UV combined with ethacridine and mifepristone for induced labor in observation group. The situations of labor induction, such as the time of labor induction, the blood loss during labor induction, the blood transfusion, the hospitalization time, and the hospitalization cost, the menstrual recovery situations after labor induction, such as the time of menstruation recovery, the menstrual cycle, the menstrual period, and the menstrual blood volume, and the levels of sex hormones, such as luteinizing hormone(LH), estradiol (E2), and follicle-stimulating hormone (FSH) of the women were compared between the two groups. The values of the coagulation indicators, such as prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and D-dimer (D-D) of the women before and after induced labor were compared between the two groups. The incidences of adverse events of induced labor, such as soft birth canal laceration, residual placenta, puerperal infection, fever, transition to cesarean section, and hysterectomy of the women in the two groups were statistically analyzed. Results: The duration of labor induction (26.5±7.9h), the blood loss during induced labor (314.5±67.5ml), the rate of blood transfusion (4.3%), and the hospital stay (5.1±1.1d) of the women in the observation group were all significantly lower than those (29.6±7.9h, 359.6±85.3ml, 15.7%, and 6.2±1.2d) of the women in the control group. The hospitalization cost (10369±547 Yuan) of the women in the observation group was significantly higher than that (5042±280 Yuan) of the women in the control group (all P<0.05). There were no significant differences in the duration of menstruation, the time of menstrual cycle, the menstrual period time, and the menstrual volume of the women between the two groups (P＞0.05). At the end of the first menstrual cycle, the levels of LH (6.57±1.32U/L) and FSH (7.23±1.44U/L) of the women in the observation group were significantly lower than those (7.06±1.64U/L and 7.92±1.51U/L) of the women in the control group, but the E2 level (134.66±7.79pg/ml) of the women in the observation group was significantly higher than that (130.53±6.62pg/ml) of the women in the control group. At 24h after induction, the values of PT, APTT, and FIB of the women in both groups were significantly higher than those before induction, and the D-D levels was significantly lower than that before induction. The levels of PT, APTT, and FIB (13.60±1.59s, 26.66±1.43s, 3.78±0.41g/L) of the women in the observation group were significantly higher than those (12.71±1.23s, 25.16±1.23s, and 3.35±0.36g/L) of the women in the control group, but the D-D level(2.31±0.34mg/L) and the total incidence of adverse events (11.4%) of the women in the observation group were significantly lower than those (3.25±0.51mg/L and 42.9% ) of the women in the control group (all P<0.05). Conclusion: UA combined with mifepristone and ethacridine used for induced labor of the pregnant women with scarred uterus and placenta previa has better clinical effect, with safety and reliability.
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