测定脐血内皮素和一氧化氮水平探讨米索前列醇足月妊娠引产的安全性

目的 探讨米索前列醇(简称米索)用于足月妊娠引产对胎儿的近期安全性。方法 106例符合条件的足月妊娠初产妇,随机分为米索50μg组56例,米索25μg组50例,分别以米索50μg、25μg放置于阴道后穹窿,3 h 1次,直至临产停药,一日用药以4次为限。选择同期住院,自然临产的初产妇56例为对照。分别用放射免疫法和硝酸还原酶法测定3组新生儿出生后第一次呼吸建立之前脐静脉血ET-1和NO水平。 结果 米索25μg组与50μg引产成功率、3组间分娩方式、羊水粪染、胎儿窘迫发生率、新生儿出生后评分及新生儿体重差异均无显著性(P>0.05);3组间脐静脉血内皮素和一氧化氮水平差异无显著性(P>0.05)。 结论 米索前列醇25μg、50μg阴道放置用于足月妊娠活胎引产对胎儿安全,建议使用50μg组更为有效。

Endothelin and nitric oxide concentrations in umbilical vein plasma in misoprostol induced labor

Objective To explore the short-term safety of misoprostol to fetuses and newborns in induced term labor. Methods 106 eligible primiparas at full pregnancy were randomly divided into two groups: 56 subjects were vaginally administered with misoprostol for 50?g every 3 hours, and 50 subjects 25?g. Misoprostol were given every 3 hours, with maximum of 4 time a day, till onset of labor. Another 56 primiparas were selected as controls, Umbilical vein blood was taken before the first breath of neonate, and endothelin (ET) concentrations were measured with RIA, and nitric oxide (NO) levels were determined with nitrite reductase assay. Results There was no statistical difference in the success rate of labor induction between the two misoprostol groups. No differences were noted among the three groups in terms of method of delivery, amniotic fluid contamination with meconium, fetal distress, Apgar scores, and birth weight. Concentration of ET and NO were comparable among the three groups. Conclusion 50?g or 25?g misoprostol, given vaginally every 3 hours, was safe in induced labor for term pregnancy, and a 50?g dosage was recommended.