间苯三酚抑制地诺前列酮引产诱发的子宫过度刺激

Investigation of the effects of Phloroglucinol on Uterine superstimulation associated with dinoprostone cervical ripening and labor induction

目的:探讨间苯三酚能否有效抑制地诺前列酮引产过程中发生的子宫过度刺激。方法:选择有引产指征的初产妇1239人,其中140人在应用地诺前列酮引产过程中发生了子宫过度刺激,将其中60人随机入实验组在发生子宫收缩异常时取出普贝生同时给予间苯三酚80mg静推,其余80人为对照组,发生子宫收缩异常时取出普贝生,给予持续吸氧、持续胎心监护。观察两组产程时间、羊水性状、产后出血量、妊娠结局、新生儿Apgar评分等指标。结果:间苯三酚组和对照组相比:①对产程的影响,间苯三酚组和对照组的活跃期比较(P>0.05),第一产程比较(P>0.05)均无显著性差异,但第二产程比较(P<0.05)有显著性差异;②间苯三酚组与对照组的羊水粪染率比较(P<0.05)有显著性差异,但两组的新生儿Apgar评分(P>0.05)无显著性差异;③两组的剖宫产率(P>0.05)及产后出血量比较(P>0.05)均无显著性差异。结论:当地诺前列酮引产过程中出现子宫过度刺激时使用间苯三酚是可行而且安全的,间苯三酚能够有效缩短第二产程的同时不增加产后出血,降低羊水胎粪污染率且对新生儿的Apgar评分无不良影响,但是间苯三酚的应用并不能显著改善妊娠引产的结局。

Objective： To investigate the effects of Phloroglucinol on Uterine superstimulation associated with dinoprostone cervical ripening and labor induction.Materials and Methods： A quasi-experimental study was conducted in Xi＇an No. 4 Hospital, Shan＇xi,fromApril 1, 2010 to March 1, 2012. A total of 1239 primigravid women dealed with dinoprostone cervical ripening and labor induction,140 of them happened with uterine superstimulation. When uterine hyperstimulation happened, we take out the dinoprostone first,then the study Group（n = 60） was given 80mg of Phloroglucinol and the control Group （n = 80）was given oxygen and continuous Fetal heart rate monitoring. Observe the delivery process ,the amount of postpartum hemorrhage ,amniotic fluid contamination and the perinatal results.Results： （1）Both groups have no siganificant difference （P〉0.05）in the time of the active phase and first stage of labor,but the time of second stage of labor in study group is shorter than the control group（P〈0.05 ）.（2） There was no significant difference in cesarean section rate ,the amount of postpartum hemorrhage and the perinatal results between the two groups （P〉0.05）,but the amniotic fluid contamination of the study group was better than the control group （P〈0.05）.Conclusion： Phloroglucinol are effective and safe to deal with uterine superstimulation associated with dinoprostone cervical ripening and labor induction. Phloroglucinol can shorten the second stage of labor ,alleviate the amniotic fluid contamination ,and have no side effect to the baby,but the Clinical outcomes were similar among the groups.