地诺前列酮栓用于足月妊娠促宫颈成熟及引产效果的研究

Dinoprostone for Cervical Ripening and Artificial Labor Effect in Term Pregnancy

目的探讨地诺前列酮栓用于足月妊娠促宫颈成熟及引产的效果。方法选取孕37-42周宫颈条件不成熟、有引产指征而无禁忌证孕妇77例,随机分为3组,即A组：单纯给予催产素,29例;B组：催产素加地诺前列酮栓,23例：C组：单纯予以地诺前列酮栓,25例;通过上述方法促宫颈成熟,比较3组孕妇用药后宫颈Bishop评分变化、阴道分娩率、第一产程、第二产程、住院时间等指标,研究相关药物及其组合的效果。结果地诺前列酮栓促宫颈成熟显效率为80.00%、总改善率为92.00%,明显高于催产素组的44.83%和68.97%,差异有统计学意义（均P〈0.05）;A组阴道分娩比例（62.07%）明显少于B、C两组（86.96%和88.00%）,差异有统计学意义（均P〈0.05）,而B、C两组间差异无统计学意义;A组阴道分娩孕妇的第一产程、第二产程均长于B、C两组,差异有统计学意义（均P〈0.05）,而B、C两组间差异无统计学意义。C组住院时间均短于A、B两组,差异有统计学意义（均P〈0.05）,而A、B两组间差异无统计学意义。B、C两组地诺前列酮栓用药至临产时间比较差异无统计学意义;A、B、C 3组胎儿窘迫发生率及新生儿窒息发生率比较差异均无统计学意义。结论地诺前列酮栓用于足月妊娠促宫颈成熟及引产有效、安全、省时,推荐单独使用。

Objective To explore the effects of dinoprostone for cervical ripening and artificial labor in term pregnancy.Methods Seventy-seven pregnant women at 37 to 42 weeks of gestation without any severe complication were randomly divided into three groups：group A,oxytocin alone,n=29;group B,oxytocin＋dinoprostone,n=23;group C,dinoprostone alone,n=25.The maternal cervical Bishop score,vaginal delivery rate,first stage of labor,second stage of labor,and hospital stay were compared among three groups.Results The effective rate（80.00%）and total improvement rate（92.00%）of cervical ripening by dinoprostone were obviously higher than those by oxytocin（44.83%,68.97%）with the difference being statistically significant（P〈0.05）.The vaginal delivery rate in group A（62.07%）was lower than in groups B（86.96%）and C（88.00%）（P〈0.05）.The first stage of labor and the second stage of labor in group A were longer than in groups B and C（P〈0.05）.There was no statistically significant difference in vaginal delivery rate,the first stage of labor and the second stage of labor between groups B and C.The hospital stay in group C was shorter than in groups A and B（P〈0.05）,but there was no statistically significant difference between groups A and B.There was no significant difference in the time from dinoprostone given to labor starting between groups B and C.There was no statistically significant difference in fetal distress and neonatal asphyxia among three groups.Conclusion Dinoprostone was effective,safe and time-saving for cervical ripening and artificial labor in term pregnancy.