普贝生用于足月妊娠促宫颈成熟的临床观察

目的 评价普贝生促宫颈成熟的有效性和安全性.方法 采用病例对照研究,将180例足月妊娠、有引产指征的初产妇随机分为两组,研究组80例以普贝生引产,对照组100例以缩宫素引产,比较两组孕妇用药前后的宫颈 Bishop评分、临产情况、分娩情况、产后出血、对新生儿的影响.结果 研究组孕妇用药后6h、12 h宫颈Bishop评分分别为 (5.9±1.1)分和 (7.0±1.5)分,明显高于对照组 (4.0±1.3)分和 (4.0±1.4)分.研究组用药至胎儿娩出时间为 (14.4±5.5)h,对照组为(23.0±6.0)h.结论 普贝生能够有效地促进宫颈成熟.     

COOK宫颈球囊扩张器用于高危妊娠促宫颈成熟的效果观察

目的:观察COOK宫颈球囊扩张器用于高危妊娠促宫颈成熟的效果。方法:选择100例足月高危妊娠初产妇,按随机数字表分为观察组与对照组,各50例。观察组使用COOK宫颈球囊扩张器,对照组使用缩宫素。比较两组干预前后的宫颈Bishop评分、促宫颈成熟率、第一产程、第二产程、总产程、产后24 h出血量、住院时间、引产成功率、阴道分娩率、宫颈裂伤、阴道血肿、产后出血发生率、新生儿体质量、Apgar评分、新生儿窒息率与窘迫率。结果:干预后观察组的宫颈Bishop评分高于干预前与对照组(P0.05)。观察组促宫颈成熟率为76.00%,高于对照组(P0.05)。观察组第一产程与总产程均短于对照组(P0.05),产后24 h出血量与住院时间更低(P0.05)。观察组引产成功率与阴道分娩率为74.00%、70.00%,均高于对照组(P0.05),两组新生儿体质量、Apgar评分、宫颈裂伤、阴道血肿、新生儿窘迫、新生儿窒息发生率的差异均无统计学意义(P0.05)。结论:COOK球囊宫颈扩张器在高危妊娠产妇中的应用可有效促宫颈成熟并扩张宫颈,缩短产程、减少出血并提高阴道分娩率,且不会增加宫颈裂伤、阴道血肿、新生儿窘迫与窒息,操作简单、安全有效,值得临床推广。     

普贝生用于足月妊娠促宫颈成熟的临床观察

目的探讨普贝生用于足月妊娠促宫颈成熟的安全性及有效性。方法对160例符合促宫颈成熟指征,元引产及用药禁忌症的足月妊娠孕妇随机分为2组：催产素组静脉点滴催产素,普贝生组阴道后穹窿放置普贝生。结果普贝生组与催产素组比较,促宫颈成熟率、用药至临产时间及分娩结局均有显著差异,P〈0．05;2组间副反应及新生儿结局差异无显著性。结论阴道后穹窿放置普贝生是一种安全、有效、方便的妊娠晚期促宫颈成熟方法,值得临床应用。     

控释前列腺素E2栓剂与催产素引产效果评价

目的评价控释前列腺素E2（商品名：普贝生）栓剂引产的安全性及有效性。方法病例对照研究的方法,选择114例孕妇,其中54例采用小剂量催产素引产,60例采用普贝生,通过比较两组用药前后的宫颈Bishop评分、临产时间、第一产程时间、第二产程时间来评价其引产的有效性;通过比较两组间出现高张宫缩、过频宫缩、宫缩乏力、新生儿窒息率、胎儿窘迫发生率、剖宫产率及自然分娩率等因素来评价其引产的安全性。采用SPSS软件处理所得数据。结果普贝生组促宫颈成熟作用明显高于催产素组（显效率94.2%∶11.1%）;普贝生组临产时间（912±334分∶2309±1042分;）、第一产程时间（307±94分∶538±152）均明显短于催产素组;普贝生组剖宫产率明显低于催产素组（13.3%∶31.2%）,自然分娩率明显高于催产素组（86%∶55%）;宫缩乏力的发生率明显低于催产素组（22.2%∶6.6%）;普贝生组在高张宫缩、过频宫缩、新生儿窒息率、胎儿窘迫发生率方面与催产素组无显著差异。结论与小剂量催产素引产相比较,普贝生具有良好的促宫颈成熟作用,在足月引产的使用中是安全有效的。     

足月孕妇应用球囊宫颈扩张器配合人工破膜引产的疗效观察

目的 对球囊宫颈扩张器配合人工破膜引产应用于足月孕妇的临床疗效观察。方法 选择 2015年10月～2017年3月在我院产科住院并应用一次性球囊宫颈扩张器促宫颈成熟共计372例足月孕妇为研究对象,随机将其分为实验组及对照组,每组186例。实验组给予人工破膜术+缩宫素引产,对照组给予缩宫素引产。两组放置球囊宫颈扩张器后宫颈Bishop评分、第一产程、顺产率、剖宫产率、引产失败率等对比分析。结果 两组放置球囊宫颈扩张器后宫颈Bishop评分高于放置球囊宫颈扩张器前,实验组第一产程短于对照组、顺产率高于对照组、剖宫产率低于对照组,对照组引产失败率高于球囊组,对比均具有统计学差异（P<0.05）。实验组及对照组产后出血量、新生儿Apgar评分、新生儿窒息发生与宫内感染发生无统计学差异（P>0.05）。结论 球囊宫颈扩张器可明显促进宫颈成熟,球囊宫颈扩张器配合人工破膜术引产成功率高,剖宫产及引产失败率降低,且不增加胎儿宫内窘迫、新生儿窒息率及宫内感染率,是安全有效的。     

普贝生用于足月妊娠引产的临床研究

目的研究普贝生的临床引产效果,与催产素进行比较。方法收集我院2007年1月-7月无规律宫缩产妇100例,半数作为研究组给予后穹窿放置普贝生以促宫颈成熟,待宫颈开至3-5cm,或出现宫缩过强、胎儿宫内窘迫时取出,对照组给予催产素;对比两组总产程、阴道出血量、新生儿窒息率、剖宫产率、副作用等临床指标。结果研究组产程明显缩短,阴道出血量少,新生儿窒息率无明显增加,而剖宫产率降低。结论普贝生促进宫颈成熟效果明显优于催产素,临床使用安全可靠。     

米索前列醇不同给药途径用于计划分娩的临床观察

米索前列醇用于晚期妊娠促宫颈成熟及引产与催产素相比具有使用方便、成本低、引产成功率高等优点[1].其应用方式大多采用阴道置药,而对于胎膜早破、宫颈评分较低等需终止妊娠者,单次阴道置药引产不易成功,多次肛诊或阴道诊又增加宫内感染的机会,所以我们采用晨起口服米索前列醇与阴道置药相结合的方法,用于计划分娩,以缩短总产程时间,提高引产成功率.     

应用普贝生促宫颈成熟后对阴道分娩、围产儿结局的影响

目的探讨应用普贝生促宫颈成熟后对各个产程、产后出血及围产儿结局的影响。方法将有指证终止妊娠的200例宫颈未成熟足月妊娠孕妇随机分为2组,研究组采用普贝生置阴道促宫颈成熟,24h后如未临产予催产素引产。对照组直接采用催产素引产。比较有完整产程产妇的各个产程时间,产后出血情况及两组的新生儿结局情况。结果研究组的第一产程平均（6.86±3.02h）明显短于对照组的（11.38±2.47h）,两者有显著性差异（P〈0.05）。而两组间总产程、第二、第三产程时间及产后出血量无明显差异（P〉0.05）。研究组新生儿的的高胆红素血症率明显低于对照组,两者有显著性差异（P〈0.05）,而两组间胎窘率、新生儿窒息率、转科率均无明显统计学意义（P〉0.05）。结论应用普贝生促宫颈成熟后临产后能有效缩短第一产程,降低新生儿的高胆红素血症发生率,而对产妇产后出血发生率及其他围产儿结局等并无影响。     

Foley尿管与缩宫素促足月妊娠宫颈成熟的效果对比

目的:对比Foley尿管与缩宫素促足月妊娠宫颈成熟的效果.方法:选取2018年1月到2021年1月诊治的124名足月妊娠产妇,通过随机数字表法分为常规组和研究组(n=62),分别静脉滴注缩宫素以及应用Foley尿管球囊扩张促宫颈成熟.比较两组产妇促进宫颈成熟效果、引产情况、不同时间点的Bishop评分及母婴妊娠结局.结...     

足月妊娠用普贝生引产的观察和护理

目的 观察普贝生(也叫前列腺素E2缓释剂),在产科足月单胎妊娠促进宫颈成熟及引产的效果.方法 将60例足月妊娠的孕妇按分娩的先后顺序分两组,每组各30例.实验组采用普贝生置于阴道后穹窿深部;对照组用小剂量缩宫素静滴.观察两组产程进展和新生儿评分情况.结果 实验组的产程进展较对照组快(P<0.05),但新生儿评分无明显差异(P>0.05).结论 普贝生用于单胎足月妊娠引产具有有效性和安全性.     

COOK宫颈扩张球囊与缩宫素促宫颈成熟引产的临床观察

目的 比较COOK宫颈扩张球囊与缩宫素促宫颈成熟的相关指标差异。方法 选取本院2016年12月~2017年12月的190例产妇作为研究对象,有引产指征且宫颈Bishop评分＜6分的产妇,有禁忌症的除外,评分数相同的平均分成两组,每组95例。观察组为COOK宫颈扩张球囊组,对照组为缩宫素组,分别比较两组产妇的宫颈Bishop评分、第一产程、第二产程、剖宫产率、新生儿出生体重、产后出血量及新生儿窒息率。结果 观察组产妇宫颈Bishop评分（8.8±2.4）分,高于对照组(6.3±1.30)分,差异有统计学意义（P＜0.05）;观察组产妇第一产程(6.71±1.90)h、第二产程（0.52±0.10）h,短于对照组第一产程（8.60±2.13）h、第二产程（0.67±0.16）h,差异有统计学意义（P＜0.05）;观察组产妇剖宫产率为11.57%,低于对照组的26.31%,差异有统计学意义（P＜0.05）;观察组产妇产后出血量、新生儿出生体重、新生儿窒息率与对照组比较,差异无统计学意义（P＞0.05）。结论 应用COOK宫颈扩张球囊后产妇的宫颈Bishop评分显著提高、缩短了产程,未增加分娩并发症。     

Interleukin-8 is involved in cervical dilatation but not in prelabour cervical ripening

Our aim was to determine the amount and source of interleukin (IL)-8 and to study IL-8 receptor expression in the human cervix during pregnancy and after labour. Cervical biopsies were obtained from six non-pregnant women, eight women undergoing pregnancy termination, 17 women undergoing elective caesarean section and 11 women after vaginal delivery. IL-8 levels were compared in women with and without a ripe cervix, as determined by cervical Bishop score and cervicovaginal fetal fibronectin levels. Levels of IL-8 and IL-1beta, a regulator of IL-8 expression, were determined by enzyme-linked immunosorbent assay (ELISA). IL-8, IL-1beta and IL-8 receptor proteins were localized by immunohistochemistry. Compared with late pregnancy, IL-8 levels increased after labour and vaginal delivery (P < 0.01) but there was no correlation with cervical ripening. IL-8 was localized to stromal cells, macrophages and granulocytes. There were no significant differences in IL-1beta levels between groups. IL-8 receptors were expressed primarily on granulocytes and macrophages after vaginal delivery. We conclude that IL-8 is involved in cervical dilatation but not in cervical ripening.     

宫颈分泌物胎儿纤维连接蛋白检测与宫颈长度在延期妊娠引产预测中的应用

目的探讨宫颈分泌物胎儿纤维连接蛋白（fetal fibronectin,fFN）检测与宫颈长度在延期妊娠引产预测中的应用价值。方法选择孕周41～41＋6周无明显剖宫产指征及妊娠并发症并自愿要求阴道试产的孕妇96例进行宫颈分泌物fFN检测及阴道超声测量宫颈长度,按催产素引产常规引产,并记录取样至分娩时间。结果宫颈分泌物fFN阳性组、宫颈长度小于3.0cm组3d内引产分娩率均明显高于宫颈分泌物fFN阴性组、宫颈长度大于3.0cm组（91.9%、81.3%VS27.3%、25.0%,P均〈0.01）。宫颈长度小于3.0cm的宫颈分泌物fFN阳性组〈24、〉72、24～72 h引产成功率均明显高于宫颈长度大于3.0cm的宫颈分泌物fFN阳性组（60.0%、6.7%、33.3%VS 0、42.9%、57.1%,P均〈0.01,P〈0.05）。结论宫颈分泌物fFN检测联合宫颈长度测定进行引产预测,可提高引产成功率。     

Transvaginal ultrasonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women

The aim of this study was to evaluate the value of transvaginal sonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. One hundred and sixty-one women scheduled for labor induction underwent transvaginal ultrasonography and digital cervical examinations. Logistic regression demonstrated that cervical length and gestational age at induction, but not the Bishop score, significantly and independently predicted failed labor induction. According to the receiver operating characteristic curves analysis, the best cut-off value of cervical length for predicting failed labor induction was 28 mm, with a sensitivity of 62% and a specificity of 60%. In terms of the likelihood of a cesarean delivery for failure to progress as the outcome variable, logistic regression indicated that maternal height and birth weight, but not cervical length or Bishop score, were significantly and independently associated with an increased risk of cesarean delivery for failure to progress. Transvaginal sonographic measurements of cervical length thus independently predicted failed labor induction in nulliparous women. However, the relatively poor predictive performance of this test undermines its clinical usefulness as a predictor of failed labor induction. Moreover, cervical length appears to have a poor predictive value for the likelihood of a cesarean delivery for failure to progress.     

Effect of mifegin on the content of cyclic nucleotides in the cervical myometrium in full-term pregnancy

Cervical myometrium was examined in 22 pregnant women at 39-41 weeks gestation at risk of labor abnormalities. The patients received mifegin for preparing to labor. A new component in the mechanism of mifegin effect on the uterine cervix in full-term pregnancy was revealed: mifegin elevated the content of cAMP by 50% and almost 2-fold increased the cAMP/cGMP ratio compared to the initial level.     

欣普贝生和缩宫素对足月胎膜早破引产效果比较

目的 比较欣普贝生和缩宫素对足月胎膜早破的临床效果。方法 选择我院2017年12月~2018年5月收治的胎膜早破孕妇200例,其中92例孕妇放置欣普贝生引产的作为欣普贝生组,缩宫素引产的108例孕妇作为缩宫素组,比较两组孕妇用药后引产结局,包括宫颈评分、破膜至用药时间、用药至临产时间、总产程、引产成功率、剖宫产率、产后出血及新生儿结局。结果 两组产后2 h出血量比较,差异无统计学意义（P＞0.05）;欣普贝生组引产前宫颈评分低于缩宫素组,用药至临产时间及总产程少于缩宫素组,差异有统计学意义（P＜0.05）;欣普贝生组、缩宫素组引产成功率分别为81.52%和83.33%,绒毛膜羊膜炎率分别3.26%、3.70%,差异均无统计学意义（P＞0.05）;两组新生儿窒息、羊水粪染及胎儿窘迫发生率比较,差异无统计学意义（P＞0.05）。结论 针对足月胎膜早破,宫颈不成熟的孕妇,欣普贝生诱发宫缩快,宫缩强而协调,是安全有效的引产方式,其剖宫产率、新生儿不良结局、产后出血与使用缩宫素基本一致,不增加风险。     

Detecting Biochemical Changes in the Rodent Cervix During Pregnancy Using Raman Spectroscopy

The goal of this research is to determine whether Raman spectroscopy (RS), an optical method that probes the vibrational modes of tissue components, can be used in vivo to study changes in the mouse cervix during pregnancy. If successful, such a tool could be used to detect cervical changes due to pregnancy, both normal and abnormal, in animal models and humans. For this study, Raman spectra were acquired before, during and after a 19-day mouse gestational period. In some cases, after Raman data was obtained, cervices were excised for structural testing and histological staining for collagen and smooth muscle. Various peaks of the Raman spectra, such as the areas corresponding to fatty acid content and collagen organization, changed as the cervix became softer in preparation for labor and delivery. These findings correspond to the increase in compliance of the tissue and the collagen disorganization visualized with the histological staining. The results of this study suggest that non-invasive RS can be used to study cervical changes during pregnancy, labor and delivery and can possibly predict preterm delivery before overt clinical manifestations, potentially lead to more effective preventive and therapeutic interventions.     

Biomechanical analysis of cervix uteri in nonpregnant, pregnant and antigestagen (ZK 98 299) treated pregnant rats

The biomechanical properties of the cervix uteri of the rat were studied under different pharmacological conditions. Four groups of rats were enrolled: A. non-pregnant (N = 12), B. 18 days pregnant treated with vehicle (N = 14), C. 18 days pregnant treated with the antigestagen ZK 98 299 (Onapristone) for 19 hours (N = 15), D. 22 days pregnant during spontaneous labor (N = 12). Load-dimension curves of two 2 mm ring-preparations from each cervix were obtained by a material testing machine. The results showed that the sampling position, the cervical ripening process, and the influence of antigestagen treatment were reflected in the biomechanical and compositional parameters. In conclusion the methodology in the present study constitute a model in which the effect of pharmaca on cervical ripening can be tested. The study demonstrated that antigestagen treatment induced biomechanical changes in the cervix comparable to those occurring during physiological cervical ripening at term.