欣普贝生与地西泮联合用于足月引产50例临床观察

Clinical Studies on Combination of Propess and Diazepam for Labor Induction in 50 Cases of Full-term Pregnancy

目的探讨欣普贝生联合地西泮静脉推注用于足月妊娠引产的临床效果及母婴安全性。方法采用随机对照前瞻性研究方法,对正常单胎头位初产妇足月妊娠,宫颈评分小于6分,无瘢痕子宫,具有引产指征而无使用前列腺素禁忌症的孕妇100例,随机分成观察组50例和对照组50例,观察组阴道放入欣普贝生,有不规律宫缩时静推地西泮10mg,对照组阴道放入欣普贝生,用药12h观察用药前后宫颈Bishop评分变化及用药至分娩时间、阴道分娩率、剖宫产率、总产程、产后24h出血量和新生儿体重、Apgar评分及出现子宫过度刺激等情况的差异。结果观察组用药促宫颈成熟有效率(98%)明显高于对照组(72%)(P<0.05);观察组总产程平均为468min,阴道分娩成功率占82%,对照组总产程平均648min,阴道分娩成功率66%,两组差异有显著性(P<0.05);产后出血量、新生儿Apgar评分、新生儿体重两组差异无显著性。结论欣普贝生联合应用地西泮对足月妊娠引产安全有效。

Objective To investigate the clinical effects and safety of combination of propess and diaze- parr, used for induction of full-term pregnancy. Methods One hundred single term pregnant women with proper fetal position, and less than 6 cervical bishop score, but without any vaginal delivey and previous uterine scar were randomly divided into two groups. One was the test group, in which propess was put into the vaginal posterior fornix for 12 hours combined with diazepam intravascularly, the other was con- trol group, in which propess was put into the vaginal posterior fornix for 12 hours alone. The cervical mat,arity （by Bishop scoring） before and 12 hours after treatment, overall delivery time, vaginal delivery rate, fetal and neonatal condition were compared between two groups. Results Cervical ripening efficien- cy in test group was 98%, which was obviously higher than that in control group 72% （P 〈 0.05） . Meanwhile, in test group, the overall delivery time was 468 min, and vaginal delivery rate was 82%. In control group, the overall delivery time was 648 min, and vaginal delivery rate was 66%. Hence, there were significant defferences in the labor starting rate, the overall delivery time and vaginal delivery rate between two groups （P 〈 0.05）. But there was no significant defference in fetal and neonatal condition and postpartum hemorrhage between two groups. Conclusion Induction of delivery with propess combined with diazepam could be a feasible option, characterized by high efficacy, good adherence to protocol, low incidence of adverse events and easy management.