地诺前列酮阴道栓剂用于足月妊娠促宫颈成熟的取药时间探讨

A Research of the Take-off Time of Intravaginal Prostaglandin E2 Suppositories in Promoting Cervical Ripening of Term Pregnancy

目的探讨地诺前列酮(PGE2)阴道栓剂用于足月妊娠促宫颈成熟不同取药时间对临床效果的影响。方法选择2009年1月～2010年7月使用PGE2促宫颈成熟经阴道成功分娩的产妇58例,根据取药时间不同分为临产组(32例)、潜伏期组(26例)两组,临产组于临产后即取出PGE2,潜伏期组在进入潜伏期后立即取出,比较两组产程时间、产后出血量、新生儿情况。结果临产组第一产程、第二产程、总产程时间分别为(349±208)min、(58±44)min、(486±179)min,潜伏期组分别为(289±196)min、(61±42)min、(469±162)min,潜伏期组第一产程明显短于临产组,差异有统计学意义(P<0.05),两组第二产程、总产程时间比较差异无统计学意义(P>0.05)。临产组产后出血量为(228±124)ml,潜伏期组为(316±145)ml,差异有统计学意义(P<0.05)。两组新生儿体重及Apgar评分差异均无统计学意义(P>0.05)。结论 PGE2阴道栓剂用于足月妊娠促宫颈成熟安全有效,操作简单,但在用药过程中应加强管理,严密观察,依据产妇的具体情况严格掌握取药时间指征。

Objective To evaluate the clinical effect of different take-off times of intravaginal prostaglandin E2（PGE2） suppositories in promoting cervical ripening of term pregnancy.Methods 58 vaginal delivery women who used PGE2 suppositories to promote cervical ripening were divided into parturient group and latency period group according to different take-off times of PGE2 suppositories.Parturient group was extracted PGE2 suppositories immediately after labor occurred.Latency period group was extracted PGE2 suppositories immediately after latent phase.The labor time,postpartum blood amount,and newborn condition were compared.Results The first,second and total stage of labor time in parturient group was（349±208）min,（58±44）min,and（486±179）min respectively,but in latency period group was（289±196）min,（61±42）min,and（469±162）min respectively.The first stage of labor time in latency period group was significantly shorter than that in the parturient group（P0.05）,but there was no significant difference in the second and total stage of labor time between the two groups（P0.05）.The postpartum blood amount in parturient group and latency period group was（228±124）ml and（316±145）ml respectively,and there was significant difference（P0.05）.There was no significant difference in body weight and Apgar score of newborn between the two groups（P0.05）.Conclusion PGE2 suppositories is effective in promoting cervical ripening,but it is necessary to strengthen management and observe carefully during drug using,and handle the indication of take-off time strictly according to the condition of parturients.