控释地诺前列酮栓用于足月高危妊娠引产的疗效观察

Clinical effect of the dinoprostone on induced labor in high risk pregnancy

目的:探讨控释地诺前列酮栓用于足月高危妊娠促宫颈成熟及引产的有效性及安全性。方法:选择有引产指征的孕妇126例,随机分为控释地诺前列酮栓组(研究组)和缩宫素组(对照组)各63例。观察2组促宫颈成熟和引产成功率,用药至临产时间、产程时间及住院时间,分娩方式和结局。结果:用药12 h后,研究组宫颈评分较用药前明显提高(P<0.01),促宫颈成熟总有效率为92.1%;而对照组宫颈评分亦较用药前提高(P<0.01),促宫颈成熟总有效率为44.4%,2组总有效率差异均有统计学意义(P<0.01)。24 h内研究组中有81.0%孕妇已临产,而对照组中仅15.9%的孕妇临产,差异有统计学意义(P<0.01)。研究组阴道分娩率为79.4%,明显高于对照组的47.6%(P<0.01)。研究组产后出血量明显少于对照组(P<0.01)。2组新生儿出生1 min Apgar评分、新生儿体质量及脐动脉血p H值差异均无统计学意义(P>0.05)。结论:控释地诺前列酮栓具有持续性、缓释性和可缩复性的优点,对于宫颈评分≤5的高危妊娠孕妇,更适合使用控释地诺前列酮栓引产,临床操作简单,安全性好。

Objective： To explore the safety and efficacy of dinoprostone on induced labor in high risk pregnancy. Methods： One hundred and twenty-six pregnant women with the indications of induced labor were randomly divided into the research group（ controlled release dinoprostone suppository group） and control group（ oxytocin group）. The cervical ripening,success rate of induced labor,time from drug to labor,labor and hospital stay,delivery method and outcome in two groups were observed. Results： Compared with before treatment,the cervical score in research group increased significantly after treatment（ P〈0. 01）,the cervical ripening total effective rate was 92. 1%. Compared with before treatment,the cervical score in control group increased after treatment（ P〈0. 01）,the cervical ripening rate was 44. 4%. The difference of the total effective rate between two groups was statistically significant（ P〈0. 01）. The effects of induced labor showed that 80. 9 % pregnant women in research group and 15. 9% pregnant woman in control group were in labor within 24 h,respectively,the difference of which was statistically significant（ P〈0. 01）. The vaginal delivery rate in research group（ 79. 4%） was significantly higher than that in control group（ 47. 6%）（ P〈0. 01）,the amount of postpartum haemorrhage in research group was significantly less than that in control group（ P〈0. 01）. The differences of birth 1 min Apgar score,newborn body quality and umbilical arterial blood p H value between two groups were not statistically significant（ P〉0. 05）. Conclusions：Dinoprostone treatment is continuity,slow-releasing and contractible renaturation. The induced labor with dinoprostone is suitable for high-risk pregnant women with cervical Bishop score equal to or less than 5,which is simple and safe.