Mifepristone併用Misoprostol中止懷孕之成效

The Effect of Combined Mifepristone and Misoprostol for Pregnancy Termination

Mifepristone （RU 486）是利用拮抗黃體素之作用而使懷孕中止的，在國外的文獻探討及使用已有20年之久。衛生署於2000 年12 月28 日核准mifepristone 以四級管制藥品上市，在中止懷孕上的確提供婦女另一項安全的療法，可降低婦女使用外科手術療法所造成的危險性。有鑑於目前越來越多的婦女不願意懷孕，本院婦產科醫師為能達有效中止懷孕而採取較高劑量的mifepristone 600mg（36-48 小時內）併用misoprostol 600mcg 的療法，但在臨床上使用的效果，似乎並不如預期。為探討目前本院使用之情況，本計劃為回溯病歷檔案之研究，收案時間以 96-97 年來婦幼門診婦產科或急診就診的病患為主，利用病歷檔案方式獲得病患基本資料及其他相關資料，預期建立更完整的資料，期許併用mifepristone 和misoprostol 在中止懷孕上的成功率、副作用等，能提供更有效的治療流程、預防措施，讓民眾獲得更完善的醫療品質。

Acting as a competitive receptor antagonist at the progesterone receptor, Mifepristone (RU 486) has been used for the pregnancy termination for two decades. The Department of Health in Taiwan approved mifepristone as a fourth restrained drug on 28th December, 2000. Mifepristone provides another choice for women who want to terminate pregnancy but not taking obvious risk of surgery. Because more and more women refuse to get pregnancy, obstetricians in our hospital intended to prescribe high-dose mifepristone 600mg (36-48 hours) plus misoprostol 600 mcg for effective pregnancy termination. However, the clinical results were not anticipated. In order to explore this issue, we conducted a retrospective study on patients enrolled from the Department of Obstetrics and Gynecology and ER in 2007-2008. Basic information other relevant data were collected from the enrollers by reviewing medical records. Through these measures, we are expecting to set up a complete database to evaluate the treatment outcomes of combined mifepristone and misoprostol and thus provide high-quality medical care to our patients.