Download Неинвазивный управляемый аборт во втором триместре

Noninvasive controlled
abortion in the trimester
of pregnancy
(a 15-years experience)
N.V.Оrdzhonikidze, B.L..Gurtovoi, N.М.Каsаboulatov
Research centre of Obstetrics, Gynecology &
Perinatology
Russian Academy of Medical Sciences
High Risk Pregnancy Dept
Main trends



Search for reasonable conservatism
Maximum safety
Limited operative intervention
Objectives
Elaboration of efficient method of late
induced abortion with the purpose to
enhance its safety and reduce
complication rate.
Stages of noninvasive
controlled abortion in the II
trimester


Maturation of the uterine cervix
Activation of contractions
Neans of cervical
maturation



Prostaglandins (cerviprost, prepidilgel), intracervical, n=106
Laminaria, intracervical, (dilapan)
n=114
Step by step combination of gel and
laminaria (dilapan), n=80
Means of uterine
contractions


nalador-500 (sulproston-derivative of
prostaglandin E2(«Schering»,
Germany), n=250
prostin 15/М – derivative of
prostaglandin F2-α («Updjohn»,USA),
n=50
M.S.Burnhill indexes before and
after tretment
6
5
4
laminaria
3
cerviprost
combination
2
1
0
before treatment
after treatment
Duration of abortion depending on the
means of cervical maturation (hrs).
10
9
8
7
6
5
4
3
2
1
0
1-cerviprost,
2-laminaria,
3-combination
1
2
3
Estradiol concentration in peripheral
blood of women in the dynamics of late
induced abortion (nmol/l)
1,2- before abortion
3-cervical maturation
4,5- progress of late
abortion
6-miscarriage
7-first day after abortion
100
90
80
70
60
50
40
30
20
10
0
1
2
3
4
5
6
7
Placental lactogene concentration
in peripheral blood of women in
the process of late induced
abortion (nmol/l)
90
1,2-before abortion
3-cervical maturation
4,5-progress of late
abortion
6-miscarriage
7-first day after abortion
80
70
60
50
40
30
20
10
0
1
2
3
4
5
6
7
Cortisol concentration in peripheral
blood of women in the dynamics of late
induced abortion (nmol/l)
1400
1,2-before abortion
3- cervical maturation
4,5-progress of late
abortion
6-miscarriage
7-first day after abortion
1200
1000
800
600
400
200
0
1
2
3
4
5
6
7
17-а-oxiprogesteron concentration in
peripheral blood of women in the
dynamics of late induced abortion
(nmol/l)
18
1,2- before abortion
3- cervical maturation
4,5-progress of late
abortion
6-miscarriage
7-first day after abortion
16
14
12
10
8
6
4
2
0
1
2
3
4
5
6
7