Effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for termination of second trimester pregnancy in patients with liver dysfunction
Effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for termination of second trimester pregnancy in patients with liver dysfunction
复制标题
双球囊导管与羊膜腔内注射乳酸依沙吖啶终止肝功能不全患者中期妊娠的有效性和安全性
DOI：
10.1007/s11596-015-1401-x
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发表时间：
2015-02-01
影响因子：
--
通讯作者：
Zeng, Wan-jiang
中科院分区：
文献类型：
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作者：
Li, Na;Wu, Peng;Zeng, Wan-jiang
妊娠期重度肝功能障碍是一种少见但严重的并发症，死亡率高。本研究比较了双球囊导管与羊膜腔内注射乳酸依沙吖啶终止SLD患者中期妊娠的有效性和安全性。采用回顾性对照分析方法，对55例有引产指征的患者进行分析。Cook组23例采用Cook双球囊扩张术，EL组32例羊膜腔内注射乳酸依沙吖啶。主要结局通过成功流产率和诱导至流产间隔的差异进行评价。次要结局包括肝功能恢复和不良事件的频率。Cook方案和EL方案均有效，流产成功率分别为87.0%和93.8%（P=0.639）。Cook组和EL组的诱导至分娩间期相似（38.1 ± 21.5 vs. 41.3 ± 17.4，P=0.543）。Cook组的肝脏疾病状况较EL组严重，但两组终止妊娠后的肝脏疾病状况无显著差异，改善率也无显著差异。两种治疗均安全，两组出血和宫颈裂伤不良事件无显著差异。本研究首次比较了双气囊导尿管和乳酸依沙吖啶用于妊娠中期SLD引产的效果。
Severe liver dysfunction in pregnancy (SLDP) is rare but serious complications with high mortality rate. This study compared the effectiveness and safety of double-balloon catheter versus intra-amniotic injection of ethacridine lactate for the termination of second trimester pregnancy in patients with SLD. A total of 55 patients with indications of labor induction were enrolled and analyzed by retrospective control analysis method. Twenty-three cases adopted Cook double balloon dilation as Cook group, and 32 cases received intra-amniotic injection of ethacridine lactate as EL group. The primary outcome was evaluated by successful abortion rate and the difference in the induction-to-abortion interval. Secondary outcomes included liver function recovery and the frequency of adverse events. Both Cook and EL regimens were effective, with successful abortion rate of 87.0% and 93.8%, respectively (P=0.639). The induction-to-delivery interval was similar between Cook group and EL group (38.1 ± 21.5 vs. 41.3 ± 17.4, P=0.543). The liver disease status was more severe in Cook group than in EL group, but it did not show any significant difference after pregnancy termination between the two groups and the improvement rate also did not show any significant difference. Both treatments were safe and there was no significant difference in bleeding and cervical laceration adverse events between the two groups. Our study firstly compared double-balloon catheter and ethacridine lactate for the induction of labor in women with SLD during second trimester pregnancy.