普贝生促临产妇宫颈成熟的临床观察

目的 评价普贝生促宫颈成熟的有效性和安全性。 方法 将157例妊娠足月、宫颈Bishop评分≤5分、有阴道分娩适应证、无引产禁忌证的单胎头位孕妇分为两组 :78例给予普贝生一枚 (10mg)塞阴道促宫颈成熟作为实验组 ;79例给予美利斯200mg/d静推促宫颈成熟作为对照组。对两组用药后宫缩、胎心、宫颈成熟度改变、用药至临产时间、胎儿娩出时间及新生儿情况等进行观察。结果 用药12h后 ,实验组宫颈Bishop评分平均提高(3.17±1.38)分 ,对照组平均提高(0.52±0.13)分 ,两组间有显著性差异 ( p<0.01)。24h内实验组64.1 % (50/78)的孕妇临产 ,对照组5.1 % (4/79)的孕妇临产 ,两组间有显著性差异(p<0.01) ;实验组69.2 % (54/78)的孕妇经阴道分娩 ,用药至胎儿娩出平均时间(25.73±18.22)h,对照组29.1%(23/79)的孕妇经阴道分娩 ,用药至胎儿娩出平均时间(77.72±54.86)h ,阴道分娩率、用药至胎儿娩出时间两组间均有显著性差异(p<0.05)。两组间胎儿窘迫的发生率 ,新生儿Apgar评分均无统计学差异(p>0.05)。结论普贝生能够有效促进宫颈成熟 ,可以较安全用于临床。

Objective To evaluate the efficacy and safety of intravaginal prostaglandin E2(PGE2)pessary(propess)for cervical ripening. Methods Seventy eight patients who had entry Bishop score of5or less,carried singleton pregnancies in cephalic presentation and had reached a gesˉtational age of at least37weeks were scheduled to undergo indicated inductions of labor.Experimental group received a propess pessary inserted into vaginal for cervical ripening,while controlled group received transvenous administered sodium prasterone sulfate of200mg per day.The status of uterne conˉtractions,fetal heart rate tracing,change of cervical ripening,the time interval from induction to delivery and neonate condition were compared. Results Twelve hours after administration,Bishop score in experimental group added3.17±1.38,Bishop score in controlled group added0.52±0.13.The difˉference was significant(P<0.01).The onset of labor occurred in24hours in64.1%(50/78)of the experimental subjects,which was significantly higher than in controlled subjects(P<0.01),in which5.1%(4/79)occurred active labor.The rate of vaginal delivery in experimental group was69.2%(54/78)and in controlled group was29.1%(23/79),the difference was also significant(P<0.05).The mean time to vaginal delivery in experimental group(25.73±18.22h)was significantly shorter than that in controlled group(77.72±54.86h)(P<0.05).No significant differences were found in fetal distress or neonatal Apgar scores between the two groups(P>0.05). Conclusion Propess is affective in producing cervical ripening,and can be used safely in clinic.