地诺前列酮用于足月妊娠促宫颈成熟和引产的临床研究

Clinical application of dinoprostone suppositories for cervix ripening and inducing labor in full term pregnancies

目的观察地诺前列酮（普贝生）用于足月妊娠促宫颈成熟和引产的临床效果和安全性。方法将486例妊娠足月、有引产指征的初产妇按抽签法分为2组，观察组269例将地诺前列酮栓1枚置于阴道后窟窿深处，对照组217例予缩宫素2．5IU加入5％葡萄糖500ml中静脉微泵泵入。比较2组用药后临产情况、剖宫产率对母婴的影响。结果观察组引产成功212例（78．8％），剖宫产37例（13．8％），对照组引产成功127例（58．5％），剖宫产69例（31．8％）。观察组新生儿窒息、羊水类染，产后出血分别为7例（2．6％）、28例（10．4％）、20例（7．4％），对照组分别为9例（4．1％）、17例（8．8％）、21例（9．7％），2组差异无统计学意义（P〉0．05）。观察组有16例（5．95％）产妇发生宫缩过频过强，取出地诺前列酮后好转。结论地诺前列酮能有效地促宫颈成熟及引产，可安全用于临床。

Objective To evaluate the efficacy and safety of dinoprostone suppositories for cervical repening and inducing labor in full term pregnancies. Methods Four hundred and eighty-six cases of full-term pregnant women were randomly divided into two groups： 269 cases （study group） were given a dinoprostone suppositories pessary, while 217 cases （control group） were given Oxytocin. The labor conditions, cesarean section rate and the impact on mother and child after administration of perinatal were compared. Results Success rate of induction delivery in study group was higher than control group. 78.8% patients （212 cases） in study group had successful induction delivery and 13.8% （37 cases） had successful cesarean section In control group, 127 cases （58.5%） of induction delivery and 69 cases （31.8%） of cesarean section succeeded. There was no significance between two groups（P 〉 0.05 ）. Sixteen cases in study group had frequent and strong uterine contraction which improved after dinoprostone suppositories were removed. Conclusion Dinoprostone suppositories is effective and safe for cervical ripening and inducing labor, and can be used safely in clinic.