活跃期后继续与停止应用缩宫素对初产妇引产的影响比较

Effect comparison of continuing and stopping oxytocin in induction of labor in primipara after active period

目的比较初产妇引产确定活跃期后继续与停止应用缩宫素的分娩过程和母婴结局。方法选择通过静脉滴注缩宫素引产的初产妇673例,缩宫素连续应用组350例,缩宫素停止应用组323例。比较两组的分娩过程及母婴结局。结果两组在活跃期持续时间、第二产程时间及绒毛膜羊膜炎等方面比较差异无统计学意义。缩宫素停止应用组的缩宫素总使用量、总使用时间、剖宫产率、子宫过度刺激发生率、胎儿心率异常发生率、产后出血发生率均低于缩宫素连续应用组(P<0.05)。结论活跃期后停止继续应用缩宫素,可以减少缩宫素总量,缩短缩宫素时间,降低剖宫产、子宫过度刺激、胎心异常和产后出血的发生率,且不会延长产程,不会增加绒毛膜羊膜炎的发生率,是引产方案的一种可行性选择。

Objective To evaluate and compare the delivery process and maternal and child outcomes of perinatal women who were determined to continue or stop using oxytocin after the active period at the time of induction.Methods A total of 673 primiparas were selected to induce labor by intravenous infusion of oxytocin,350 in continuous oxytocin group,and 323 in oxytocin stop group.The delivery process and maternal and infant outcomes of the two groups were compared.Results The comparison of the two groups in terms of duration of active phase,second stage of labor and chorioamnionitis indicated no statistical significance(P>0.05).The total usage of oxytocin,total usage time,cutting contractions,incidence of uterine overstimulation,abnormal heart rate of hypertension,and incidence of postpartum hemorrhage in the oxytocin discontinuation group were lower than those in the oxytocin continuous application group(P<0.05).Conclusion Stopping oxytocin after the active period can reduce the volume of oxytocin,shorten the time of oxytocin,reduce the incidence of cesarean section,hyperstimulation,abnormal fetal heart rate and postpartum hemorrhage,but not prolong the labor process and increase the incidence of chorioamnionitis.Stopping oxytocin after the active period is a feasible option for labor induction.