普贝生与蒂落安对促进宫颈成熟和引产的效果比较

Clinical evaluation of propess and prasterone for induction of term pregnancy

目的评价普贝生(地诺前列酮)用于促宫颈成熟和引产的有效性及安全性。方法采用病例对照研究的方法,将妊娠足月单胎头位、无引产禁忌证、宫颈Bishop评分<6分的164例孕妇随机分为两组:研究组82例阴道塞普贝生一枚(10mg)促宫颈成熟,对照组82例静推蒂落安(硫酸普拉睾酮钠)200mg/d,共三天。对促宫颈成熟效果、分娩及新生儿情况进行比较。结果研究组宫颈促成熟总有效率为93.90%,对照组仅为4.88%(P<0.01)。研究组用药至出现宫缩、临产及分娩时间显著短于对照组(P<0.01),剖宫产率明显降低(研究组为25.6%,对照组为42.68%)。两组产妇总产程、产后出血量及产程中胎心异常、羊水粪染发生率无明显差异(P>0.05)。新生儿平均出生体重及窒息率亦无显著性差异(P>0.05)。结论普贝生可安全、有效地用于促宫颈成熟和引产。

Objective To evaluate the efficiency and safety of propess （Prostaland in E2） for cervical ripening and induction of term pregnancy. Methods 164 primigarae matched the requirements en- tered this case controlled study. The patients were randomly divided into two groups： 82 in propess group,and 82 in praterone group,propess group received a propess pessary inserting into posterior vaginal fornix,and controlled group was given 200mg prasterone intravenously per day for three days. Efficiency of cervical ripening, vaginal labor and newborn＇s Apgar score were compared between the two groups. Results The total efficiency of cervical ripening was 93.90% in the propess group and 4. 88% in controlled group （P 〈 0.01）. The mean time of drug administration to appearance of uterin contraction, labor starting and labor in propess group were less than controlled group （P 〈 0.01）, the ratio of cesarean section in experimental group was significantly lower than in controlled group（propess group 25.6%, controlled group 42. 68%）. No significant differences were found in the total labor time, postpartum hemorrhage, fetal heart rate disorder and meconium- stained amniotic fluid bewteen the two groups （P 〉 0.05）. The mean weight of newborn and the ratio of fetal distress were also found no significant differences between the two groups （P 〉 0.05）. Conclusions Propess is effective and safety in producing cervical ripening and inducing labor.