控释前列腺素E_2栓剂用于促宫颈成熟和引产效果

目的:探讨控释前列腺素E2栓剂用于足月妊娠促宫颈成熟及引产的有效性及安全性。方法:采用随机双盲、对照研究方法,对研究组40例足月妊娠孕妇阴道内使用E2栓剂,对照组40例静滴小剂量缩宫素。比较两组孕妇宫颈Bishop评分、分娩情况以及对胎儿、新生儿的影响。结果:①研究组用药后8、12h宫颈Bishop评分分别为6.6±1.3和7.8±1.8,明显高于对照组4.3±1.2和4.5±1.1,P<0.01;12h后宫颈成熟总有效率(93%)明显高于对照组(30%),P<0.01。②研究组24h总临产率(50%)均明显高于对照组(15%),P<0.01;阴道分娩率(55%)高于对照组(42%),P<0.05;第二产程短于对照组,P<0.01;其他2个产程及产后出血量两组无显著性差异,P>0.05。③两组新生儿结局无明显差异(P>0.05)。宫缩过度刺激为主要副作用,但取药后好转。结论:控释前列腺素E2是一种有效、安全的促宫颈成熟可用于引产的药物。

Prostaglandin E2 Preparations for Cervical Ripening and Labour Induction

Objective: To explore the efficacy and safety of Prostaglandin E_2 (PGE2) used for cervical ripening and intermediate labour induction. Methods: Prostaglandin E_2 was put into the vaginas of 40 pregnant women with uterogestation as study group, and lower dose of oxytocic was injected into the veins of 40 women as the control group by double-blind, randomized clinical study method. The cervical maturity (Bishop scoring), condition of delivery, fetal and neonatal condition in two groups were studied. Result: Bishop scores were 6.6±1.3 and 7.8±1.8 respectively in 8、12 hours after prostaglandin E_2 was placed in study group, which was significantly higher than that of control group.( 4.3±1.2,4.5±1.1,P<0.01) .Cervical ripening rate after 12 hours was 93% in study group, higher than that (30%) in control group. The total rate of labor induction was 50% after 24 hours in the study group , which was significantly higher than that (15%) of control group (P<0.01). The rate of vaginal delivery was 55% in the study group, higher that ( 42%) in control group (P<0.05). The second stage of labor was shortened obviously in study group than in control group(P<0.01). There was no difference in first and third stage of labor , postpartum hemorrhage and fetal and neonatal conditions between two groups(P>0.05). The major side-effect was over stimulation of uterine contraction. Conclusion: Prostaglandin E2 is effective and safe for cervical ripening and induction.