在妊娠24至28周之间中断妊娠的需要并不常见,通常是由于胎儿死亡或致命异常。尽管如此,在这些妊娠期,治疗选择变得更加有限,在许多情况下可能无法使用手术方法。米索前列醇加米非司酮或不加米非司酮的疗效已在妊娠早期和中期早期得到充分研究,但其超过24周妊娠的使用描述较少。本文件试图综合使用米索前列醇与或不与米非司酮一起使用的现有证据,以在妊娠24-28周时引产无法存活的妊娠。综合证据表明,联合使用米非司酮和米索前列醇的治疗方案可能会缩短排出时间,尽管总体成功率与仅使用米索前列醇的方案相似。
The need to interrupt a pregnancy between 24 and 28 weeks of gestation is uncommon and is typically due to fetal demise or lethal anomalies. Nonetheless, treatment options become more limited at these gestations, when access to surgical methods may not be available in many circumstances. The efficacy of misoprostol with or without mifepristone has been well studied in the first and earlier second trimesters of pregnancy, but its use beyond 24 weeks\' gestation is less well described. This document attempts to synthesize the existing evidence for the use of misoprostol with or without mifepristone to induce labor for nonviable pregnancies at gestations of 24-28 weeks. The composite evidence suggests that a regimen combining mifepristone and misoprostol may shorten the time to expulsion, though the overall success rates are similar to those seen with misoprostol-only regimens.