Ethacridine Generic name RIVANOL, also known as Revernol). It is a powerful antiseptic that causes contraction of the uterine muscles in vitro and in vivo. Inject 10 ml of 0.5%-1% ezacridine (containing 50-100 mg of ezacridine) into the amniotic cavity as an induction of labor, which can cause uterine contraction and induce fetal and placental expulsion. The clinical effect of induction of labor can reach 90% to 99%. Indications】 1, all 14 to 27 weeks of pregnancy to terminate pregnancy without contraindications. 2, due to a disease (including hereditary diseases) should not continue pregnancy. 3, prenatal diagnosis of fetal malformations. Absolute contraindication】 1. Those who cannot tolerate the operation due to poor general health condition. 2. Acute stage of various diseases. 3. Acute inflammation of the genital tract or skin infection at the puncture site. 4.Central placenta praevia. 5.Allergic to ezacrine. Relative contraindications】 1.Surgical scars on the body of the uterus, old lacerations on the cervix, post-electrocautery of the cervix due to chronic inflammation, and uterine dysplasia should be used with caution. 2.Two measurements (4 hours apart) of body temperature above 37.5 0C within 24 hours before surgery. Pre-operative preparation】 1.Must be hospitalized to induce labor. 2.Detailed medical history, good preoperative consultation, explain the possible complications. Both spouses should be informed and sign the consent form. 3.Take blood pressure, temperature, pulse, general and gynecological examination, pay attention to the presence of pelvic tumors, birth canal scars and deformities. 4.Check the blood and urine routine and bleeding, clotting time, blood type, electrocardiogram, hepatitis B virus surface antigen, determination of liver and kidney function. 5.The instruments and dressings used for induction of labor must be autoclaved. 6, cleaning the abdomen and perineal skin. 7, ultrasound placenta positioning and puncture point positioning as appropriate. Operation method】 1, the surgical operation should be performed in the operating room or delivery room. 2.The operator wears hand brushing clothes and pants, with cap and mask. Routinely brush hands and bring sterile gloves. 3.The patient should empty the bladder before surgery. 4.Pregnant women should be placed in a flat position, and those with large months should be placed with their heads slightly higher and feet lower. Disinfect the skin with iodine alcohol or iodophor on the abdomen, and lay a sterile hole towel. 5.Select the puncture site Fix the uterus in the middle of the lower abdomen, on the midline (or both sides of the midline) under two or three fingers of the uterine fundus, and select the most obvious part of the cystic sensation or select the puncture site according to the ultrasound positioning, avoiding the placental attachment as far as possible. 6, amniotic cavity puncture No. 7 lumbar puncture needle with core, from the selected puncture point vertical stabbing, generally through the three resistance (i.e. skin, muscle sheath, uterine wall) after a sense of falling, that is, into the amniotic cavity. When the puncture needle enters the amniotic cavity, the amniotic fluid overflows when the needle core is removed. If you see blood overflowing, do not inject medicine for the time being and adjust the puncture site and direction. Repeat the puncture no more than 2 times. 7.Inject the drug Prepare a syringe with estaacridine solution, connect it with the puncture needle, and pump a little amniotic fluid into the syringe before injecting the drug, which is flocculent after mixing with amniotic fluid. Confirm that the needle is in the amniotic cavity, and then inject the drug. Generally inject 0.5~1% estaacrine 10ml, containing 50~100mg of estaacrine. 8.Pull out the puncture needle After injecting the drug solution, pump back a small amount of amniotic fluid and then inject it again to wash the drug solution inside the syringe, then insert the needle core and pull out the needle quickly. The eye of the needle is covered with a piece of sterile gauze and compressed for a moment, and fixed with adhesive tape. Observation and treatment after induction of labor] 1, must be hospitalized for observation, medical staff should closely observe any side effects, temperature, contractions, vaginal bleeding and other conditions. 2, such as a drug injection to induce labor failed, the need for a second amniotic cavity injection to induce labor, at least 72 hours after the failure of induction before the second drug, the dose is still 50 to 100 mg. such as the failure of both induction of labor, should take other methods to terminate pregnancy. 3. After regular contractions, the pregnant woman and the progress of labor should be closely monitored. The fetus should be sent to the delivery room for delivery before delivery, and the vulva should be disinfected with disinfectant and the buttocks should be covered with sterile towels. 4.After delivery of the fetus, if there is not much bleeding, you can wait for the placenta to be delivered by itself under close observation. If the placenta has not been delivered for half an hour and there is not much bleeding, intramuscular injection of 10Iu of contraction or 0.2mg of ergotoxine should be given. 5.Check carefully whether the placenta is intact after delivery. If residue is suspected, or if the placenta is intact by visual inspection, but there is active bleeding in the vagina, immediate cleaning of the uterine cavity should be performed. Weak bleeding contractions can be injected intramuscularly with 20Iu of contractin or can be added to 250ml of 5% glucose solution or saline with 20Iu of contractin intravenously. 6. Routinely check the cervix and vagina for lacerations after abortion, and if soft birth canal lacerations are found, suture them in time. Postoperative disposition】 1.Fill in the record form for induction of labor and abortion. 2.Give antibiotics, contraction medicine and lactation return medicine after induction of labor. (1) Pay attention to vaginal bleeding, fever, chills and other signs after induction of labor, and report to the physician if abnormalities are found. (2) Pay attention to vulva cleanliness and hygiene to prevent infection. (3) Do not have intercourse or take a bath for 1 month after abortion. (4) Make instructions on contraception at the time of discharge and follow up after 1 month.