早产筛查与黄体酮阴道用药治疗先兆早产

Effects of Prematurity Screening and Vaginal Administration of Progesterone on Premature Delivery

目的探讨早产筛查与黄体酮阴道用药治疗先兆早产的效果。方法按照随机数字表法将160例有先兆早产征象的孕妇分为A组和B组,各80例,B组孕妇接受常规治疗,A组在此基础上予黄体酮阴道用药;根据孕妇先兆早产情况另将其分为重度先兆早产组(n=61)和中度先兆早产组(n=99);同时将80例正常孕妇归为对照组。对治疗效果、孕妇宫颈长度及胎儿纤维连接蛋白(fFN)进行比较。结果宫颈长度:重度先兆早产组<中度先兆早产组<对照组(P<0.05),fFN检测结果:重度先兆早产组>中度先兆早产组>对照组(P<0.05)。与B组比较,A组分娩孕周、延迟孕周时间、新生儿体质量、足月产率更高,早产率及新生儿窒息率更低(P<0.05)。与对照组比较,A组新生儿体质量更低(P<0.05);B组孕妇分娩孕周、延迟孕周时间、新生儿体质量、足月产率亦更低,但早产率及新生儿窒息率更高(P<0.05)。结论宫颈长度与fFN检测是筛查先兆早产的可靠标志物,应用黄体酮治疗先兆早产效果确切。

Objective To explore the effects of prematurity screening and vaginal administration of progesterone on premature delivery.Methods A total of 160 pregnant women with signs of threatened premature labor were randomly given conventional treatment alone（group B,n=80）or in combination with vaginal administration of progesterone（group A,n=80）.Furthermore,these pregnant women were divided into severely threatened premature labor group（n=61）and moderately threatened premature labor group（n =99）.In addition,80 healthy pregnant women were selected as the control group.Therapeutic efficacy,cervical length and fetal fibronectin（fFN）were observed.Results Compared with moderately threatened premature labor group,cervical length increased and fetal fibronectin decreased in control group,but cervical length reduced and fetal fibronectin elevated in severely threatened premature labor group（P〈0.05）.Compared with group B,pregnant weeks to labor,delayed gestational weeks,newborn weight and fullterm delivery rate increased and premature birth rate and neonatal asphyxia rate decreased in group A（P〈0.05）.Compared with control group,newborn weight reduced in group A,and pregnant weeks to labor,delayed gestational weeks,newborn weight and full-term delivery rate decreased and premature birth rate and neonatal asphyxia rate increased in group B（P〈0.05）.Conclusion Cervical length and fFN are reliable markers for screening threatened premature labor.Vaginal administration of progesterone is significantly effective for treating threatened premature labor.