摘要
目的:探讨提高米索前列醇用于晚期妊娠引产的安全性措施。方法:通过腹部检查、头盆评分、B超及胎心电子监护选择引产对象126例,随机分为两组,各63例。25微克组:米索前列醇25微克阴道用药,24小时重复一次,总量50微克。50微克组:米索前列醇50微克阴道用药,24小时重复一次,总量100微克。宫缩发动后由专人看护,并进行连续胎心、宫缩监护,直至分娩结束。用硫酸镁缓解宫缩过强。观察两组的引产成功率、促宫颈成熟效果、首次用药至临产时间、阴道分娩总产程以及分娩结局。结果:两组的引产成功率、首次用药至临产的时间及用药前后bishop评分的变化均无显著差异;25微克组阴道分娩的总产程显著长于50微克组,在Bishop评分≥5分的病例中,25微克组单次引产的成功率显著低于50微克组,二次给药后则无差异。两组均无母儿严重并发症。结论:为提高米索前列醇用于晚期妊娠引产的安全性,采用包括选择病例、合理用药及产程监护的综合措施是有益的。米索前列醇25微克阴道用药、24小时重复一次、总量50微克的用药方案作用温和,安全度高,值得推荐。
Objective: To explore the measures for increasing safety of misoprostol for induction of labor in the third trimester of pregnancy. Method: To adopt open clinic-controlled trial. 126 selected patients were randomly derived into two groups: 25 ug (25 ug of intrav-aginal misoprostol) and 50 ug group (50 ug of that), with 63 patients for each group. The drug was inserted again after 24 hours, the total drug amounts of 50 ug and 100 ug were used in 25 ug group and 50 ug group erspectively. After contraction initiation it was put under close monitoring until the end of delivery, adopting magnesium sulphate to alleviate uterine over-efficiency within duration of labor. Observe the change of Bishop score, success rate for induction of labor, interval between drug insertion and onset of labor, total duration of labor for vaginal delivery and fetomaternal complicaiton in the two groups. Results:The success rates for induction of labor were 90. 5% for the 25 ug group, 92.1% for the 50ug group. There was no significant difference between the two groups (P>0. 05). The Bishop scores rose notably before and after drug insertion (P<0. 05), and were not singificantly different between the two groups. The interval between the first drug insertion and the total druation of labor for the vaginal delivery for 25 ug group were much longer than those for 50 fig group (P<0. 01 and P<0. 001 respectively). Incidences for uterine over-efficiency, dejecta inquination of amniotic fluid, fetal distress and neonatal asphyxia were not remarkable difference for the two groups. Conclusions: It is suitable for promoting cervical ripeness, increasing safety of misoprostal for induction of labor in the third trimester of pregnancy, that 25ug of intravaginal misoprostol was inserted and repeated again after 24 hours with total drug amounts of 50 ug. However, it is necessary to draw up the usage rule for misoprostol.
出处
《上海生物医学工程》
2000年第1期50-53,共4页
Shanghai Journal of Biomedical Engineering
关键词
米索前列醇
晚期妊娠
引产
安全性
Misoprostol third trimester of pregnancy Induction of labor
