3种引产方法在足月妊娠中应用的比较

THE CLINICAL COMPARISON OF THREE INDUCED LABOR METHODS APPLIED TO COMPLETE PREGNANCY

目的 :比较 3种引产方法在足月妊娠中应用的效果。方法 :将 16 0例有引产指征的足月单胎头位妊娠 ,无宫缩 ,宫颈Bishop评分≥ 5分的初产妇分成 3组 ,米索前列醇组 (6 0例 )用米索前列醇 5 0 μg阴道后穹窿放置 ,每 3h1次 ,总量≤ 15 0μg;气囊宫颈扩张组 (4 0例 )用气囊宫颈扩张后人工破膜 ,低浓度催产素静滴 ;催产素组 (6 0例 )低浓度催产素静滴引产。结果 :3组引产成功率比较 ,米索前列醇组明显高于气囊组和催产素组 (均 P <0 .0 5 ) ,气囊宫颈扩张组高于催产素组 (P <0 .0 5 ) ;3组引产成功阴道分娩总产程比较 ,米索前列醇组明显短于气囊宫颈扩张组和催产素组 (均 P <0 .0 5 ) ,气囊宫颈扩张组短于催产素组 (P <0 .0 5 ) ;3组在剖宫产率、产后出血量、产褥病发生、急产发生、新生儿窒息发生方面比较无显著性差异 (P >0 .0 5 )。结论 :阴道放置米索前列醇用于足月妊娠引产较气囊宫颈扩张和催产素引产更有效、安全 。

Objective:Through the comparison of the 3 mduced labor methods applied to the complete pregnancy,to probe into a more effective and safer method for induced labor Methods:160 cases of patients of single pregnancy,cephalic presentation with an indication of induced labor,no uterine contraction,a cervical Bishop score≥5,were divided into 3 groups For the misoprostol group(60cases),50μg misoprostol was placed in the posterior fornix of the vagina every 3 hours with a total dose≤150 μg;for the balloon cervical dilation group (40cases),fetus membrane was artificial broken after the dilation of the balloon cervical Meanwhile,intravenous infusion of low concentrated oxytocin was necessary And for the oxytocin group(60cases),induced labor was performed together with intravenous infusion of low concentrated oxytocin Results:To compare the induced labor between the 3 groups,the success rate of the misoprotol group is obviously higher than that of the balloon cervical dilation group (P<0 05) and the oxytocin group (P<0 05);while the balloon cervical dilation group higher than the oxytocin group (P<0 05) Howver,to compare the total birth process of the vaginal labor with successful induced labor among the 3 groups,the time needed for the misoprostol group is clearly shorter than that for the balloon cervical dilation group (P<0 05)and oxytocin group (P<0 05);while the balloon cervical dilation group shorter than the exytocin group (P<0 05) As for the cesarean section rate,the postpartum hemorrhage,the morbidity of puerperalism,the emergent delivery and the neonate asphyxia,there are no obvious differences between the 3 groups Conclusion:As for the induced labor of the complete pregnancy,vaginal administration of misoprostol is a more effective way,while the way of the balloon cervical dilation is merely a complementary one