控释前列腺素E_2栓剂用于促宫颈成熟和引产效果

目的探讨控释前列腺素E2栓剂用于足月妊娠促宫颈成熟及引产的有效性及安全性。方法采用随机双盲、对照研究方法,对研究组40例足月妊娠孕妇阴道内使用E2栓剂,对照组40例静滴小剂量缩宫素。比较两组孕妇宫颈Bishop评分、分娩情况以及对胎儿、新生儿的影响。结果①研究组用药后8、12h宫颈Bishop评分分别为6.6±1.3和7.8±1.8,明显高于对照组4.3±1.2和4.5±1.1,P<0.01;12h后宫颈成熟总有效率(93%),明显高于对照组(30%),P<0.01。②研究组24h总临产率(50%),均明显高于对照组(15%),P<0.01;阴道分娩率(55%)高于对照组(42%),P<0.05;第二产程短于对照组,P<0.01;其他2个产程及产后出血量两组无显著性差异,P>0.05。③两组新生儿结局无明显差异(P>0.05)。宫缩过度刺激为主要副作用,但取药后好转。结论控释前列腺素E2是一种有效、安全的促宫颈成熟可用于引产的药物。

Objective To explore the efficacy and safety of continuously released prostaglandin E2 （PGE2） supposltory-propess usee fo rcervical ripening and artificial labor in term pregnancy. Methods A double-blind, random ized, casecontrol clinical study was conducted. The experimental group （40 cases ）received a propess pessary inserted into vaginal for cervical ripening, while controlled group （40 cases ）receive transvenous drip infusion low close oxytocin. The status of change of cervical ripening, uterne contractions ,the time interval from induction to delivery, fetal heart rate tracing, and neonate condition were compared. Results （1）Bishop score was 6.6± 1.3 and 7.8±1.8 respectively after using propess 8 and 12 hours in the experimental group, which was significantly higher than that of controlled group （4.3 ± 1.2,4.5 ± 1.1, respectively,P〈0.01）.The total effective ratewas obviously higher in experimental group han in controlled group（93%： 30% ,P〈0.01）. （2）The onset of labor occurred in 24 hours was 50% in the experimental subjects , which was significantly higher than 15% in controlled subjects（P〈0.01）. The rate of vaginal delivery in the experimental group was 55% and in controlled group was 42%, the difference was also significant （P〈0. 05）. The second stage of labor to vaginal delivery in experimental group was significantly shorter than that in controlled group （P〈0.01）. No significant differences were found in the first stage of labor and third stage of labor and postpartum hemorrhage （P〉0.05）. （3）No significant differences were found in neonatal Apgar scores between the two groups （P〉0.05）. The major side effect of propess was over stimulation of uterine contraction, But it can be well after take out of the drug. Conclusion Continuously released prostaglandin E2 can be used for cervical ripening and rtificial labor safely and effectively.