地诺前列酮栓在足月妊娠引产中的应用

目的 探讨地诺前列酮栓（商品名：欣普贝生）应用于足月妊娠的引产效果.方法 选择中山大学附属第三医院有引产指征的足月妊娠孕妇97例,研究组35例为胎膜早破,对照组62例胎膜未破,均使用欣普贝生引产,比较两组的引产效果以及分娩结局.结果 研究组12h内促宫颈成熟有效率为100%,对照组为93.44%;研究组用药后6h、12h宫颈Bishop评分均高于对照组（P＜0.05）;研究组用药至临产时间（6.27±6.13）h、用药至分娩时间（12.15±7.51）h、总产程（6.10±2.60）h,均短于对照组[分别为（9.56±8.51）h、（17.02±10.49）h、（7.93±3.87）h,P均＜0.05];研究组剖宫产率为22.86%、产后出血2例、胎儿窘迫2例、无新生儿窒息,与对照组差异均无统计学意义（对照组分别为22.58%、3例、5例、2例,P均＞0.05）.结论 欣普贝生可安全有效地用于足月妊娠的引产;欣普贝生对于足月胎膜早破孕妇的促宫颈成熟及诱发宫缩的起效作用较胎膜完整孕妇更快.     

欣普贝生应用于临床的效果分析及护理

目的 总结欣普贝生促进足月妊娠宫颈成熟及引产的临床效果与护理方法.方法 对31例住院孕妇应用欣普贝生,然后观察其宫颈成熟度改变、临产时间、分娩方式和母婴结局及用药后的不良反应.结果 用药后宫颈成熟度改变显效29例,占93.5%;引产成功30例,占96.7%;分娩结局为阴道分娩25例,占80.6%;新生儿出生时Apgar评分7～10分28例,占90.3%;孕妇出现呕吐2例.结论 欣普贝生用于足月妊娠促宫颈成熟及引产效果显著,加强对其的观察和护理,能有效缩短临产时间,提高引产成功率,从而降低因宫颈条件差引产失败所导致的剖宫产,增加孕妇阴道分娩信心.     

宫颈扩张球囊与欣普贝生应用于促宫颈成熟及引产的临床效果

目的 比较宫颈扩张球囊与欣普贝生应用于促宫颈成熟及引产的临床效果差异.方法 我院2022年3月至2023年6月收治的90例引产产妇,以随机数字法分为参照组和研究组,每组各45例.参照组实施欣普贝生促宫颈成熟及引产,研究组应用宫颈扩张球囊促宫颈成熟及引产.观察两组引产情况、宫颈评分、产程和出血量、新生儿结局以及不良反应发生率.结果 研究组的引产总有效率、产后Bishop评分与参照组比较无差异(P>0.05).研究组的引产至临产时间、引产至分娩时间长于参照组,24h分娩率低于参照组,比较差异有统计学意义(P<0.05).研究组的总产程时间及产后出血量与参照组比较无显著差异(P>0.05).研究组的不良反应发生率低于参照组,比较差异有统计学意义(P<0.05).结论 应用宫颈扩张球囊可有效促进产妇宫颈成熟,其引产效果与欣普贝生的效果相近,但是安全性相较于欣普贝生更好.     

地诺前列酮用于羊水偏少促宫颈成熟的临床观察

【目的】探讨地诺前列酮（PGE2,欣普贝生）用于足月妊娠羊水偏少促宫颈成熟的安全性及有效性。【方法】对212例羊水偏少符合促宫颈成熟指征,无引产及用药禁忌证的足月妊娠孕妇随机分为两组：催产素组（n=102）和欣普贝生组（n=110）,催产素组静脉点滴催产素,欣普贝生组阴道后穹隆放置欣普贝生。观察两组促宫颈成熟的安全性及有效性。【结果】欣普贝生组用于羊水偏少引产,促宫颈成熟有效率高,总产程短,阴道分娩率高（P〈0．01）,对新生儿不良影响小;但需要密切观察宫缩及胎心,以防胎儿窘迫的发生。【结论】欣普贝生用于足月妊娠羊水偏少引产安全、有效。     

欣普贝生用于足月妊娠促宫颈成熟的观察护理

目的 观察欣普贝生用于足月妊娠促宫颈成熟的引产效果,总结护理要点。方法 从2010年1～8月入产房进行欣普贝生引产孕妇中选择50例无阴道分娩禁忌、无使用欣普贝生引产的禁忌症、单胎头位、足月待产的初孕妇作为观察组,阴道后穹隆内使用欣普贝生栓剂一枚10mg;同期选取50例无引产干预措施的、自然阴道分娩、足月单胎头位的初孕妇作为对照组。分析宫颈Bishop评分及有效率、显效率、成功率;比较两组产程长短、产后2h出血量、新生儿Apgar评分;观察并总结欣普贝生在引产过程中的护理要点。结果 观察组用药前、用药后12h宫颈Bishop评分有显著的统计学差异(P<0．01);12h宫颈成熟显效率78．3％,有效率89．1％;成功率92．0％;观察组第一产程时间明显短于对照组,差异有显著性(P<0．01);两组产后2h出血量、新生儿Apgar评分、差异无显著性(P>0．05)。结论 欣普贝生是安全、有效的促宫颈成熟之引产药     

欣普贝生对足月妊娠促宫颈成熟及引产的效果分析

选取2013年2月~2015年7月在我院住院具有引产指征的孕妇200例,将其分为研究组和对照组各100例。研究组孕妇采用欣普贝生引产,对照组采用小剂量催产素进行引产。对比两组孕妇的引产成功率、新生儿情况及分娩情况。研究组孕妇在引产成功率、宫颈成熟率上均优于对照组,剖功率明显低于对照组,两组对比差异显著(P0.05),新生儿情况比较,无显著差异(P0.05)。欣普贝生对足月妊娠促宫颈成熟及引产具有显著的效果,与催产素相比,其效果更为显著,并且安全可靠,值得大力推广。     

普贝生在足月妊娠引产中的应用

目的 探讨足月妊娠引产方法选择.方法 将本院2008-09-2009-11有引产指征的足月妊娠孕妇120例,随机分成两组.研究组以普贝生阴道用药配合催产素静脉滴注,对照组为小水囊配合催产素引产.比较两组孕妇促宫颈成熟度,引产成功率及分娩情况.结果 普贝生组促宫颈成熟效果明显优于小水囊组,用药至临产时间显著短于小水囊组,引产成功率高于对照组,对母婴影响无明显差异.结论 普贝生促宫颈成熟及引产效果均优于小水囊,且用药安全方便.     

欣普贝生促宫颈成熟引产与分娩60例护理观察

[目的]观察欣普贝生促宫颈成熟引产的临床效果及其护理观察。[方法]将113例足月妊娠孕妇随机分为研究组60例,对照组53例,研究组将1枚欣普贝生放置于阴道后穹窿,12 h后取出;对照组仅给予缩宫素静脉输注引产,比较两组引产过程胎儿宫内窘迫及分娩情况。[结果]研究组引产效果明显优于对照组(P<0.01),对母婴影响差异无统计学意义。[结论]欣普贝生是一种安全有效的促宫颈成熟引产药物,对婴儿无明显不良影响。     

欣普贝生促宫颈成熟引产与分娩60例护理观察

[目的]观察欣普贝生促宫颈成熟引产的临床效果及其护理观察。[方法]将113例足月妊娠孕妇随机分为研究组60例,对照组53例,研究组将1枚欣普贝生放置于阴道后穹窿,12 h后取出;对照组仅给予缩宫素静脉输注引产,比较两组引产过程胎儿宫内窘迫及分娩情况。[结果]研究组引产效果明显优于对照组（P〈0.01）,对母婴影响差异无统计学意义。[结论]欣普贝生是一种安全有效的促宫颈成熟引产药物,对婴儿无明显不良影响。     

欣普贝生在妊娠晚期促宫颈成熟及引产中的应用

[目的]评价欣普贝生在妊娠晚期促宫颈成熟及引产的疗效及安全性.[方法]选取2009年1月-2010年6月住院分娩的符合纳入标准的初产妇共244例进行回顾性分析,按使用药物的不同分为缩宫素组和欣普贝生组,比较两组产程以及分娩结局.[结果]欣普贝生组24 h内临产率达到84.55%,明显高于缩宫素组;欣普贝生组从用药到临产时间是(5.58±3.85)h、总产程为(5.85±2.20)h、第1产程为(4.51±1.85)h,均短于缩宫素组(P<0.05).[结论]欣普贝生促宫颈成熟及引产有效、方便、安全.     

地诺前列酮栓、米索前列醇及缩宫素在足月胎膜早破患者中的应用效果比较

目的比较地诺前列酮栓、米索前列醇及缩宫素在足月胎膜早破患者中的应用效果。方法将我院收治的300例足月胎膜早破患者随机分为研究组(100例,米索前列醇)、观察组(100例,地诺前列酮栓)及对照组(100例,缩宫素)。比较三组的治疗效果。结果研究组与观察组的宫颈成熟率及阴道分娩率均高于对照组,剖宫产率及并发症总发生率均低于对照组,用药至临产时间、用药至分娩时间及总产程均短于对照组(P<0.05),但研究组与观察组的上述指标均无显著差异(P>0.05)。三组的各项Apgar评分及总分均无显著差异(P>0.05)。结论地诺前列酮栓及米索前列醇在足月胎膜早破患者中具有相近的治疗效果,二者促宫颈成熟的效果及引产效果均优于缩宫素,并发症发生率均低于缩宫素。     

地诺前列酮栓在足月妊娠促宫颈成熟引产中应用的疗效观察及护理

目的观察地诺前列酮栓用于促宫颈成熟引产的治疗效果及护理要点。方法选取我院妇产科2009年12月至2011年1月收治的92例孕产妇,随机分为观察组和对照组各46例,观察组孕产妇采用地诺前列酮栓引产,对照组用催产素引产。比较2组的应用效果。结果观察组治疗效果显著,宫颈评分用药12h后较用药前明显提高,且与对照组比较,有显著差异;观察组临产时间、总产程及分娩时间等指标明显低于对照组;引产成功率为91．3％,明显高于对照组的引产成功率80．4％。结论地诺前列酮栓适用于足月妊娠促宫颈成熟引产的治疗,且安全、可控,疗效好。     

具有回复系统的控释地诺前列酮阴道栓剂用于足月胎膜早破病例引产的临床研究

目的：探讨具有回复系统的控释地诺前列酮阴道栓剂（欣普贝生）用于足月胎膜早破病例引产的有效性及安全性。方法：52例足月胎膜早破需要引产孕妇以随机列表法分为观察组（30例）和对照组（22例）,分别用欣普贝生和缩宫素引产。比较两组产妇促子宫颈成熟有效率、子宫颈Bishop评分、临产及分娩时间、新生儿情况及药物不良反应。结果：观察组用药24h内有效29例,无效1例,总有效率为97%。对照组24h内有效6例,25～48h有效8例,49～72h有效4例,无效4例,总有效率为82%。观察组均于48h内终止妊娠,其用药24h子宫颈Bishop评分明显高于对照组（P〈0.05）。用药后观察组的临产时间及总产程分别为（9.2±5.7）、（26.4±9.5）h,均短于对照组相应的（7.3±5.4）、（11.9±5.0）h（P〈0.01或0.05）。观察组阴道分娩20例（67%）,对照组阴道分娩14例（64%）,两组的阴道分娩率比较差异无统计学意义（P〉0.05）。观察组发生胎儿窘迫3例,新生儿窒息1例;对照组发生胎儿窘迫2例,无发生新生儿窒息者。两组胎儿窘迫发生率、新生儿窒息率比较差异均无统计学意义（P〉0.05）。观察组发生子宫收缩过频3例,产后出血1例（3%）,对照组无上述不良反应发生。结论：欣普贝生用于足月胎膜早破病例引产,促子宫颈成熟有效率高,临产时间快,总产程短,对新生儿不良影响小,但使用时须密切观察孕妇子宫收缩及胎心情况,以防产后出血的发生。     

Cook球囊与缩宫素用于足月孕妇促宫颈成熟及引产效果观察

目的利用Cook球囊对足月孕妇进行促宫颈成熟和引产,以评价其用于足月妊娠孕妇促宫颈成熟的可行性和护理对策。方法50例孕妇按其意愿分为两组,观察组26例采用Cook球囊引产,对照组24例采用普通催产素引产,比较两组分娩方式、产程、出血量和新生儿状况。结果观察组72h内引产成功22例（84．6％）,72h后引产成功2例（7．7％）,转剖宫产2例（7．7％）;对照组72h内引产成功17例（70．8％）,72h后引产成功3例（12．5％）,转剖宫产4例（16．7％）。两组72h引产成功率和剖宫产率差异有统计学意义（P〈0．05）。观察组促宫颈成熟有效率92．3％,对照组83．3％,差异有统计学意义（z=9．815,P=-0．000）。两组产妇第一产程和总产程差异有统计学意义（P〈0．01）,第二产程和第三产程差异无统计学意义。两组产妇分娩时、产后2h出血量和新生儿出生体重、Apgar评分差异均无统计学意义。结论Cook球囊引产可提高产妇宫颈成熟度、提高引产成功率,有临床应用价值。     

二对一全程陪伴分娩对降低剖宫产率的影响

目的:探讨二对一全程陪伴分娩对降低正常产妇剖宫产率的影响。方法:选择518例初产妇作为研究对象,将其分为实验组和对照组,实验组108例实行家属和助产士共同陪伴进行分娩,对照组410例采用传统的分娩模式,比较两组产时的心理状态,药物引产率和剖宫产率。结果:实验组产妇分娩时心理状态相对稳定,药物引产率和剖宫产率均低于对照组,差异有统计学意义(P<0.05,P<0.01)。结论:二对一全程陪伴分娩使产妇身心更为安全,健康,减少药物干预,降低剖宫产率,是一种值得推广的产时服务模式。     

米索前列醇-耦合剂凝胶用于足月妊娠促宫颈成熟的临床观察

目的观察小剂量米索前列醇-耦合剂凝胶用于足月妊娠促宫颈成熟的效果及安全性。方法足月妊娠具备引产指征的产妇122例纳入研究,试验组62例,对照组60例,前者采用米索前列醇-耦合剂凝胶对比后者米索前列醇阴道后穹隆给药促宫颈成熟。结果试验组足月妊娠促宫颈成熟的总有效率为83.9%,显著高于对照组的65.0%(P<0.05),剖宫产率亦低于对照组(P<0.05),但新生儿出生体质量及新生儿窒息率与对照组比较差异无统计学意义(P>0.05)。结论小剂量阴道后穹窿米索前列醇-耦合剂凝胶用于足月妊娠促宫颈成熟是一种安全有效的方法,对母儿无明显不良影响。     

Acupuncture for cervical ripening and induction of labor at term--a randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate whether acupuncture at term can influence cervical ripening, induce labor and thus reduce the need for postdates induction. METHODS: On the estimated date of confinement (EDC) women were prospectively randomized to an acupuncture group (AG) or a control group (CG). Data of 45 women were evaluated (AG, n = 25; CG, n = 20). Inclusion criteria were as follows: confirmed EDC, uncomplicated course of pregnancy, singleton pregnancy in cephalic presentation. Exclusion criteria were as follows: cervical dilation > 3 cm, active labor, premature rupture of membranes, previous cesarean section, pathologies in mother or fetus. Women were examined at 2-day intervals. The cervical length was measured with vaginal ultrasonography, cervical mucus was obtained for a fetal Fibronectin test and the cervical status was assessed according to the Bishop score. In the AG, the points Hegu (Large Intestine 4) and Sanyinjiao (Spleen 6) were pierced on both sides every second day. If women were not delivered 10 days after EDC, labor was induced by administering vaginal prostaglandin tablets. RESULTS: The cervical length in the AG was shorter than that in the CG on day 6 and day 8 after EDC (P = 0.04 for both). In the AG the time period from the first positive Fibronectin test to delivery was 2.3 days, while that in the CG was 4.2 days (P = 0.08). The time period from EDC to delivery was on average 5.0 days in the AG and 7.9 days in the CG (P = 0.03). Labor was induced in 20% of women in the AG (n = 5) and in 35% in the CG (n = 7) (P = 0.3). Overall duration of labor, and first and second stage of labor were not different in the two groups. In 56% of women who underwent acupuncture (n = 14) and in 65% of controls (n = 13), Oxytocin was used to augment labor. (P = 0.54). CONCLUSION: Acupuncture at points LI4 and SP 6 supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery.     

Randomized study of vaginal misoprostol (PGE(1)) and dinoprostone gel (PGE(2)) for induction of labor at term.

OBJECTIVES: To investigate the efficacy and safety of misoprostol in the induction of labor at term by comparing this agent with the commonly used dinoprostone gel. PATIENTS AND METHODS: A randomized clinical trial of vaginal misoprostol, 50 microg 6-hourly, and dinoprostone gel, 1-2 mg 6-hourly, in 435 women undergoing induction of labor at term. The women, 210 in the misoprostol group and 225 in the dinoprostone group, were compared to determine whether there was a significant difference in achieving vaginal delivery within 24 h, the incidence of hyperstimulation syndrome, Cesarean section rate and adverse neonatal outcome. They were also offered the option of preinduction sonographic cervical assessment. RESULTS: Misoprostol, compared to dinoprostone gel, was associated with a significantly shorter median induction-to-delivery interval (14.6 h vs. 19.0 h; P = 0.0014), a higher incidence of vaginal delivery within 24 h of induction (65.7% vs. 54.2%; P = 0.019) and a reduced need for oxytocin augmentation during labor (20.5% vs. 29.8%; P = 0.034). The groups did not differ significantly in the rates of Cesarean section (18.1% vs. 19.1%; P = 0.88) and hyperstimulation syndrome (2.4% vs. 0.9%; P = 0.27). None of the cases of hyperstimulation required treatment with tocolysis. All nine cases of excessive uterine contractility occurred after the first dose of the drug. There were no significant differences in maternal and neonatal morbidity between the two groups. There was a significant association between preinduction cervical length and the induction-to-delivery interval in both those receiving misoprostol and those treated with dinoprostone. CONCLUSIONS: The use of misoprostol is associated with a shorter duration of labor and a higher rate of vaginal delivery within 24 h from induction without an increase in maternal and neonatal morbidity. Transvaginal sonographic measurement of cervical length is useful in the prediction of the likelihood of vaginal delivery within 24 h of induction and of the induction-to-delivery interval and may be useful in the stratification of patients participating in randomized studies that examine the effectiveness of inducing agents.     

Use of misoprostol for cervical ripening

BACKGROUND: Misoprostol, the prostaglandin E1 analog, is increasingly used for cervical ripening and induction of labor. We evaluated our experience with misoprostol in an open-label setting. METHODS: Patients were selected for cervical ripening based on clinical profile. At 3 cm cervical dilation, misoprostol was discontinued and other means of labor augmentation were used. Over 13 months, 470 inductions of labor occurred, and 455 charts were available; 254 patients (56%) received misoprostol for cervical ripening, and 144 (32%) received dinoprostone (prostaglandin E2). RESULTS: With misoprostol, mean time from beginning of contractions until delivery was 7 hours, 30 minutes; vaginal birth occurred in 85% of cases, and spontaneous labor occurred in 38%. Hyperstimulation occurred in 4 cases (1.6%) and precipitate labor in 7 (3%). All infants were discharged in excellent condition; one had a 5-minute Apgar score <7, and 33 (13%) had meconium, none with aspiration. Twenty-three patients who had had a previous cesarean section received misoprostol and delivered vaginally. CONCLUSION: Misoprostol was found to be a safe and effective agent for cervical ripening as part of labor induction.     

地诺前列酮阴道栓剂用于足月妊娠促宫颈成熟的取药时间探讨

目的探讨地诺前列酮(PGE2)阴道栓剂用于足月妊娠促宫颈成熟不同取药时间对临床效果的影响。方法选择2009年1月～2010年7月使用PGE2促宫颈成熟经阴道成功分娩的产妇58例,根据取药时间不同分为临产组(32例)、潜伏期组(26例)两组,临产组于临产后即取出PGE2,潜伏期组在进入潜伏期后立即取出,比较两组产程时间、产后出血量、新生儿情况。结果临产组第一产程、第二产程、总产程时间分别为(349±208)min、(58±44)min、(486±179)min,潜伏期组分别为(289±196)min、(61±42)min、(469±162)min,潜伏期组第一产程明显短于临产组,差异有统计学意义(P<0.05),两组第二产程、总产程时间比较差异无统计学意义(P>0.05)。临产组产后出血量为(228±124)ml,潜伏期组为(316±145)ml,差异有统计学意义(P<0.05)。两组新生儿体重及Apgar评分差异均无统计学意义(P>0.05)。结论 PGE2阴道栓剂用于足月妊娠促宫颈成熟安全有效,操作简单,但在用药过程中应加强管理,严密观察,依据产妇的具体情况严格掌握取药时间指征。