足月妊娠引产时延长地诺前列酮放药时间的疗效观察

Effect of controlled-release dinoprostone for longer period in labor induction at term

目的研究足月妊娠引产时应用地诺前列酮(普贝生)延长放药时间最长至24小时的疗效及其不良反应。方法对2007年1月1日至2008年12月31日使用普贝生引产的足月孕妇的病历资料进行回顾性分析,其中12小时内未取药未临产的患者160例作为研究对象,对12小时取出药物者(A组,52例)与继续放药最长至24小时者(B组,108例)进行比较,包括:基本情况、临床疗效(主要包括阴道分娩率、宫颈评分改善情况、催产素使用率)。结果两组基本情况比较差异无统计学意义。在放药12小时未临产且无其他取药指征的产妇中,进一步延长放药时间最长至24小时能显著改善宫颈评分,提高临产率,降低催产素的使用率,最终提高阴道分娩率。而母儿并发症的发生率无显著增加。延长普贝生放药时间提高引产成功率的主要原因在于有许多产妇在放药的12～24小时内发生临产。结论普贝生用于足月妊娠引产时,如12小时未临产,延长放药时间可以进一步改善宫颈评分、增加阴道分娩率、降低催产素的使用率,且不增加母儿并发症。

Objective To investigate the effect of controlled-release dinoprostone （ Propess ） for up to 24 hours in la- bor induction at term. Methods Records of labor induction in term pregnancy using Propess in our hospital were reviewed and those who used Propess for 12 hours or longer were studied. Propess were removed at 12 hours in 52 pa- tients （Group A） and retained at 12 hours but no longer than 24 hours in 108 patients （Group B）. Vaginal delivery rate, cervical Bishop score improvement, oxytocin infusion rate were compared between the two groups. Results Re- tain the Propess for longer time up to 24 hours can further improve the Bishop score. Labor rate and vaginal delivery rate were increased and further oxytocin infusion rate was decreased significantly in group B compared with group A. There was no increase in main maternal and fetus side-effects in group B compared with group A. Many women pro- gressed to labor between the 12 and 24 hours after the initial insert of Propess which improved the effect of Propess in group B and was probably the result of continuous release of dinoprostone for 24 hours. Conclusion The effect of controlled-release dinoprostone （Propess） for labor induction at term can be improved when retained for up to 24 hours without significant increase of side effects.