胎盘后血中肾上腺髓质素水平与子宫收缩强度的相关性研究

目的:探讨胎儿外监护仪在产力监测中的价值以及胎盘后血中肾上腺髓质素(ADM)的浓度与子宫收缩强度之间的关系。方法:78例产妇根据分娩方式分为3组:阴道自然分娩组,阴道分娩但使用缩宫素组,阴道助产与剖宫产组。应用胎儿外监护仪并根据MU计算3组子宫收缩强度,用放射免疫的方法测定胎盘后血中的ADM的浓度。结果:3组潜伏期sMU值比较无差异,阴道助产与剖宫产组活跃期sMU值明显低于经阴道自然分娩组,且胎盘后血中ADM浓度明显高于经阴道自然分娩组。结论:胎儿外监护仪虽然可以评估产力的变化,但是子宫收缩强度个体间差异较大,因此监测每个产妇产程过程中产力的动态变化更有助于及时发现异常情况;ADM可能抑制子宫平滑肌的收缩,其机理尚需进一步探讨。

Investigation on the correlation between the adrenomedulin level in retroplacental blood and contraction intensity of uterus

Objective: To explore the value of fetal monitor in the monitoring of force at" labor, the level of adrenomedulin in retro-placental blood and the relationship between adrenomodulin level and contraction intensity of uterus. Methods: 78 pregnant women were di-vided into 3 groups according to delivery modes: vaginal delivery group, vaginal delivery and oxytocin group, midwifery and caesarean sec-tion group. Fetal monitor was used in the study, the contraction intensity of uterus was calculated by Montevideo unit (MU), the level of ad-renomedulin was detected by radioimmunonssay. Results: There was no significant difference in sMU of latent phase among three groups,sMU of active phase in midwifery and caesarean section group was lower than that in vaginal delivery group, but the level of adrenomedulin in retreplaeental blood reversed. Conclusion: Fetal monitor can evaluate the change of force of labor, but the contraction intensity of uterus varies in different women, thus the dynamic monitoring of force of labor conduces to the early diagnoeis of abnormal conditions; adrenomedu-lin repress the contraction intensity of uterus, but the mechanisms is unknown.