米索前列醇阴道后穹窿给药用于足月妊娠引产90例临床分析

Clinical study of misoprostol placed in the posterior fornix of vagina for inducing term labor.

目的 探讨小剂量米索前列醇 (米索 )用于足月妊娠引产的有效性和安全性。方法 A组 90例根据宫颈Bishop评分阴道后穹窿首次置米索 2 5～ 5 0 μg ,观察宫缩情况 ,若无规律宫缩则每 3小时置药一次 (2 5 μg) ,直至出现规律宫缩 ,总量不超过 2 0 0 μg ;B组 90例 ,静滴催产素引产作为对照组。 结果 两组引产成功率分别为87 78%和 80 0 0 %(P >0 0 5 )。A组从开始用药至临产时间较B组明显缩短 (P <0 0 5 )。初产妇宫颈评分≤ 5分者 ,A组引产成功率高于B组 (P <0 0 5 ) ,两组剖宫产率 ,产时出血量及新生儿窒息的发生率均无显著性。结论 小剂量重复阴道后穹窿给米索用于足月妊娠引产 ,是一种安全。

Objective To study the efficacy and safety of misoprostol placed in the posterior fornix of vagina for inducing term labor.Methods 90 women(group A)receinved initially 25～50μg misoprostol placed in the posterior fornix of vagina according to Bishop scores of cervix,25μg misoprostol was given vaginally every 3 hours until the regular uterine contraction appeared.The total dosage was less than 200μg per day.90 subjects of group B received intravenous oxytocin as controls.Results The success rate of labor induction was 87\^78% in group A and 80\^00% in group B(P>0\^05).The average interval from start of labor induction to onset of labor in group A was significantly shorter than that in group B(P<0\^05).When the cervix of primipara was unfavorable for induction(Bishop score≤5),the success rate in group A was higer than that in group B(P<0\^05).There was no significant differences in the incidence of cesarean section,volume of bleeding and neonatal asphyxia between the two groups.Conclusion It is safe and effective to induce term labor by repeatedly placing lower dosage misoprostol in the posterior fornix of vagina.