地诺前列酮与缩宫素用于足月妊娠引产效果的临床观察

目的：探讨地诺前列酮用于足月妊娠促宫颈成熟及引产的有效性及安全性。方法：选择220例足月妊娠单胎头位、无引产禁忌的初产妇和经产妇,采用双盲对照研究的方法随机分为两组,观察组110例采用阴道后穹隆放置地诺前列酮1枚引产,对照组110例以缩宫素静滴引产,对两组宫颈成熟Bishop评分,对产程的影响,引产成功率,阴道分娩率及对胎儿和新生儿的影响进行比较。结果：观察组促宫颈成熟效果明显优于对照组（P〈0.01）;用药至临产的时间观察组显著短于对照组（P〈0.01）;观察组12h临产率为67.3%,24h临产率为87.3%,对照组12h临产率为46.4%,24h临产率为70.0%,两组比较,差异有统计学意义（P〈0.01）;观察组引产成功率高于对照组,观察组阴道分娩率为65.5%,对照阴道分娩率为51.8%,两组差异有统计学意义（P〈0.05）;对母婴的影响两组差异无统计学意义。结论：地诺前列酮用于初产妇和经产妇的促宫颈成熟及诱发宫缩作用优于缩宫素,它可以显著提高宫颈Bishop评分,从而提高阴道分娩率,促进自然分娩,临床应用简便、安全、有效,值得产科临床推广使用。

Clinical observation of dinoprostone suppositories and oxytocin for labor induction in full-term pregnancy

Objective：To explore the efficacy and safety of dinoprostone suppositories for cervical ripening and labor induction in full-term pregnancy.Methods：220 cases of full-term pregnant wonen who were with single fetus,head presentation and without any vaginal delivery contraindication were divided into two groups according to the randomized double-blind study.The observation group（n=110） were placed a piece of dinoprostone suppositories in posterior fornix,the control group were treated with oxytocin in the induction process.The changes of cervical ripening（Bishop）,the success rate of labor induction,the total stages of labor,the vaginal elivery rate,the influence on fetus and newborns were observed as the clinical evaluation after the treatment.Results：The degree of cervical ripening in the observation group was higher than in the control group（P〈0.01）;the interval from medication to labor was shorter（P〈0.01）.The 12 h labor rate was 67.3% and the 24 h labor rate was 87.3% in the observation group;the 12 h labor rate was 46.4% and the 24 h labor rate was 70.0% in the control group;the differences of the two groups were significant（P〈0.01）.The success rate of labor induction in the observation group was higher than that in the control group.The vaginal elivery rate was 65.5% in the observation group and 51.8% in the control group（P〈0.05）.The influence on mother and infant in the two groups showed no significant difference.Conclusion：Dinoprostone suppositories can increase the degree of cervical ripening and contract uterine revulsant,which is superior to those of oxytocin.Dnoprostone suppositories can significantly increase Bishop score and the vaginal elivery rate,which is convenience,safety,efficiency,and is worthy of clinical application in obstetrics.