欣普贝生用于足月胎膜早破低宫颈评分引产的效果观察

目的:探讨欣普贝生(地诺前列酮栓)在足月胎膜早破初产孕妇中应用的安全性及有效性。方法:100例足月胎膜早破单胎孕妇,破膜2h后未临产,宫颈条件未成熟(宫颈Bishop评分≤4分),孕妇知情同意后欣普贝生组入组50例,催产素组50例。比较两组的分娩方式及母儿结局情况。结果:与催产素组比较,欣普贝生组8h、12h促宫颈成熟总有效率明显增加(92.0%vs 64.5%,P0.01;95.9%vs 79.2%,P0.05)。欣普贝生组阴道分娩率明显升高(86.0%vs 60.0%,P0.01),且欣普贝生组用药12h、24h内阴道分娩率亦显著提高(42.0%vs 8.0%,P0.001;64.0%vs 34.0%,P0.01)。欣普贝生组用药至临产、用药至阴道分娩时间明显短于催产素组[(7.4±1.0)h vs(14.2±2.0)h,P0.01;(15.4±1.4)h vs(21.4±1.6)h,P0.01]。欣普贝生组引产失败率、绒毛膜羊膜炎发生率显著降低(2.0%vs 16.0%,P0.05;0 vs 12.0%,P0.05);两组急产、胎儿宫内窘迫、相对性头盆不称发生率无明显统计学差异;两组均无产后出血、新生儿窒息。结论:足月胎膜早破且宫颈条件未成熟的初产孕妇,应用欣普贝生促宫颈成熟安全、有效,且效果优于直接催产素引产,但用药期间应加强母儿监护。

Vaginal prostaglandin E2 for labor induction in premature rupture of membranes at term with low Bishop score

Objective:The aim of this study was to compare the efficacy and safety of a prostaglandin E2 ( PGE2 ) vaginal insert with those of oxytocin for labor induction in premature rupture of membranes ( PROM) at term with low Bishop score in nulliparous women. The pres-ent study also examined whether its use increase the rate of vaginal delivery in them. Methods:A total of 100 PROM women with singleton pregnancies at term,Bishop scores of≤4 were as-signed to receive either oxytocin or vaginal PGE2 in the context of informed consent. There are 50 cases in the vaginal PGE2 group and the oxytocin group,respectively. The primary outcomes were time from induction to vaginal delivery and mode of delivery. Results:Compared with the oxytocin group,the total effective rate of cervical ripening was obviously increased in the PGE2 group after 8 and 12 hours ( 92 . 0% vs 64 . 5%, P<0 . 01;95 . 9% vs 79 . 2%, P<0 . 05 ) . The vaginal delivery within 12 and 24 hours were significant raised in the PGE2 group (42. 0% vs 8. 0%,P<0. 001;64. 0% vs 34. 0%,P<0. 01) and the total vaginal delivery rate was in-creased (86. 0% vs 60. 0%,P<0. 01). The time from labor induction to active labor onset and vaginal delivery were significantly shorter in the PGE2 group than those in the oxytocin group (7. 4±1. 0 vs 14. 2±2. 0h,P<0. 01;15. 4±1. 4 vs 21. 4±1. 6h,P<0. 01). The incidence of in-duction failure and chorioamnionitis were declined in the PGE2 group (2. 0% vs 16. 0%,P<0 . 05;0 vs 12 . 0%, P<0 . 05 ) . There were no statistically significant difference in the rates of precipitate labor,fetal distress and relative cephalopelvic disproportion of the two groups. Neo-natal outcomes were comparable in both groups. Conclusion:It was safe and efficient to use va-ginal administration of PGE2 treatment for cervical ripening and induction of term pregnancy with PROM in nulliparous women,and its efficacy was superior to oxytocin,however,monitoring should be intensified.