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米索前列醇阴道给药与催产素浓缩液和PGE_2阴道给药对妊娠中期引产作用的比较
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作者 ramsey p.s. Savage K. +2 位作者 Lincoln T. Owen J. 刘亦恒 《世界核心医学期刊文摘(妇产科学分册)》 2005年第8期41-42,共2页
OBJECTIVE: To compare the efficacy, side effects, and complications of high-dose vaginal misoprostol with concentrated intravenous oxytocin plus low-dose vaginal prostaglandin (PGE2) for second-trimester labor inducti... OBJECTIVE: To compare the efficacy, side effects, and complications of high-dose vaginal misoprostol with concentrated intravenous oxytocin plus low-dose vaginal prostaglandin (PGE2) for second-trimester labor induction. METHODS: One hundred twenty-six consenting women with maternal or fetal indications for pregnancy termination and no prior cesarean delivery were randomly assigned to receive either vaginal misoprostol 600 μg1 ×, 400 μg every 4 hours 5×.(misoprostol group, n = 60) or escalating-dose concentrated oxytocin infusions (277-1,667 mU/min) plus vaginal PGE2 10 mg every 6 hours 4×. (oxytocin group, n = 66). Both groups received concurrent extra-amniotic saline infusion for cervical ripening. Women who failed their assigned regimen received 20 mg of PGE2 suppositories every 4 hours until delivery. Analysis was by intent to treat. RESULTS: Demographic characteristics were similar between study groups. Median induction-to-delivery interval was significantly shorter in the misoprostol group (12 hours) than in the oxytocin group (17 hours; P < .001). There was a higher induction success rate at 24 hours in the misoprostol group (95%) than in the oxytocin group (85%; P = .06), although this difference did not reach statistical significance. The incidence of live birth (25%versus 17%), chorioamnionitis (5%versus 2%), and postpartum hemorrhage greater than 500 mL (3%versus 3%) were similar between the misoprostol and oxytocin groups, respectively. Diarrhea (2%versus 11%; P = .04), nausea/emesis (25%versus 42%; P = .04), and retained placenta requiring curettage (2%versus 15%; P = .008) were significantly less common in the misoprostol group when compared with the oxytocin group, respectively. Isolated intrapartum fever, however, was more frequent in the misoprostol group (67%) than in the oxytocin group (21%; P < .001). CONCLUSION: Compared with concentrated oxytocin plus low-dose vaginal PGE2, high-dose vaginal misoprostol is associated with significantly shorter induction-to-delivery intervals, fewer side effects, a lower incidence of retained placenta, and comparable incidence of live birth. 展开更多
关键词 中期引产 PGE2 浓缩液 阴道给药 宫颈成熟 引产成功率 终止妊娠 羊膜腔 活产率 绒毛膜羊膜炎
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妊娠中期羊水中基质金属蛋白酶-8的水平高于第90百分位数可预测随后的早产胎膜早破
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作者 Biggio Jr. J.R. ramsey p.s. +1 位作者 Cliver S.P. 高雪莲 《世界核心医学期刊文摘(妇产科学分册)》 2005年第6期13-14,共2页
We sought to determine whether midtrimester amniotic fluid levels of matrix metalloproteinase- 8 were associated with subsequent preterm premature rupture of membranes. We conducted a case- control study examining 57 ... We sought to determine whether midtrimester amniotic fluid levels of matrix metalloproteinase- 8 were associated with subsequent preterm premature rupture of membranes. We conducted a case- control study examining 57 asymptomatic women who underwent genetic amniocentesis from 14 to 21 weeks’ gestation and subsequently had preterm premature rupture of membranes (< 35 wk) and 58 women with subsequent term delivery. Measurement of total matrix metalloproteinase- 8 level in amniotic fluid was conducted using a commercially available enzyme- linked immunosorbent assay and association with preterm birth due to preterm premature rupture of membranes was assessed. The overall distribution of matrix metalloproteinase- 8 concentrations was similar in women who had preterm premature rupture of membranes and term controls (median 2.39 ng/mL, 25th to 75th percentile 1.1- 10.1 vs 2.37 ng/mL, 25th to 75th percentile 1.5- 4.7, P =. 94). However, 26% of women who had preterm premature rupture of membranes had a matrix me- talloproteinase- 8 concentration above the 90th percentile (8.7 ng/mL), compared with only 10% of term controls (odds ratio 3.1, 95% CI 1.1- 8.7; P =. 03). Elevated matrix metallopro- teinase- 8 remained associated with preterm premature rupture of membranes after adjustment for maternal age, race, parity, gestational age, and year of amniocentesis (odds ratio 3.4, 95% CI 1.2- 9.9; P =. 03). The overall distribution of midtrimester amniotic fluid matrix metalloproteinase- 8 levels did not differ between women who had preterm premature rupture of membranes and those delivered at term. However, marked elevations of midtrimester amniotic fluid matrix metalloproteinase- 8 were highly associated with subsequent preterm premature rupture of membranes, suggesting that the pathophysiologic processes that contribute to preterm premature rupture of membranes may begin in early pregnancy. 展开更多
关键词 早产胎膜早破 妊娠中期 百分位数 基质金属蛋白酶 羊膜腔穿刺 足月分娩 染色体检查 妊娠早期 基质蛋白 周和
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