摘要
目的:探讨地诺前列酮(普贝生)重复给药、延长给药用于足月妊娠促宫颈成熟及引产的有效性及安全性。方法:选取正常单胎头位足月妊娠,具有引产指征而无使用前列腺素禁忌证的孕妇148例,使用普贝生引产。常规给药组60例:给药1次,放药时间≤12h。重复给药组48例:连续给药2次,第1次放药时间12h,第2次放药时间≤12h;延长给药组40例:给药1次,放药时间12～24h;3组孕妇在给药前、给药后6h、12h及24h经阴道检查进行宫颈Bishop评分,观察给药至出现临产的时间、总产程、阴道分娩率、缩宫素使用率、产后24h出血量和新生儿体重、Apgar评分及有无不良反应等。结果:用药后24h常规给药组促宫颈成熟显效率最高(66.7%),重复给药组引产有效率最高(87.5%),用药至临产的时间以常规给药组为最短(16.9±8.05h)。3组中重复给药组总产程最短,阴道分娩率最高,缩宫素使用率最低。产后出血量、新生儿体重及新生儿Apgar评分3组无显著差异。常规给药组和延长给药组中各有1例因不良反应终止用药,停药后反应消失。结论:普贝生用于足月妊娠促宫颈成熟有效率及引产成功率高,重复给药可改善单次用药临产率较低的情况,亦安全有效。延长药物放置时间可在一定程度上进一步促进宫颈成熟。
Objective：To explore the clinical efficacy and safety of the patients using the dinoprostone（propess） twice or extending 12 hours to ripen cervix and induce labor in term pregnancy. Methods： One hundred and forty-eight cases of term monocyesis with cephalic presentation and indication of labor induction without prostaglandin usage contraindications were chosen to induce labor with propess. They are divided into three groups. Medicine routine group （60 cases） singly used propess in no more than 12 hours,continual group （48 cases） used propess twice,12 hours in the first stage and no more than 12 hours in the second stage. The time of using propess in prolong group （40 cases） extended to 12 - 24 hours singly. Take vaginal examination in three groups to estimate cervical ripening by Bishop score at following points：before the medicine was used,6 hours, 12 hours and 24 hours later. The time of labor starting, the stage of labor, the ratio of vaginal delivery, the application of oxytocin, the postpartum hemorrhage,the weight of neonatal,the Apgar score and the side-effects were compared among the three groups. Results：The efficacy of cervical ripening was 66.7% in routine group, the efficacy of labor induction was 87.5% in continual group, the time to labor starting was16.9 ±8.05 hour in routine group. The continual group had the shortest stage of labor,the highest vaginal labor ratio and the least rate of using oxytoxin. There were no significant differences among those three groups in postpartum hemorrhage, newborn weight and Apgar score. Both routine and prolong group had one ease of therapy discontinuity due to side-effect, which disappeared after ending the therapy. Conclusion： Propess is effective to ripen the cervix and successful in labor induction. Properly continual used Propess twice has higher labor starting ratio than singly used propess and is still safe and effective. Prolong using it properly is effective to ripen the cervix.
出处
《现代妇产科进展》
CSCD
北大核心
2008年第3期194-197,共4页
Progress in Obstetrics and Gynecology
关键词
地诺前列酮
前列腺素
宫颈成熟
引产
Dinoprostone
Prostaglandins
Cervical ripening
Labor,induced
