晚期妊娠米索前列醇引产指征的探讨  

Study of the Indication of Induced Labor by Misoprostol In Late Trimester of Pregnancy

作　　者：尹春艳[1] 王保平[1] 吕小燕[1] 贾晓江[1] 李秋玲[1] 胡玉风[1] 

机构地区：[1]广东省第二人民医院产科,510317

出　　处：《中国误诊学杂志》2005年第2期201-203,共3页Chinese Journal of Misdiagnostics

基　　金：广东省医学科研基金资助项目(编号:A2002547)

摘　　要：目的探讨应用胎儿纤维结合素(FFN)测定结合Bishop评分,对小剂量米索前列醇(Misoprostol简称米索)用于足月妊娠引产的安全性及有效性评价,分析晚期妊娠米索引产指征。方法随机选择无米索引产禁忌证的、孕周≥40周孕妇104例分为3组组FFN阴性/Bishop<7分20例;组FFN阳性/Bishop<7分50例;组FFN阳性/Bishop≥7分34例,25μg米索阴道后穹窿放置,记录放置米索的总量、引产成功率、产程、羊水粪染率、剖宫产率,进行统计学处理。结果组引产成功率较低,用药次数增多,潜伏期易发生子宫收缩不协调,引起潜伏期延长,需用催产素加强宫缩的增多;组引产成功率高,发生宫缩过强、子宫过度刺激综合征、羊水粪染等并发症机率低;组引产成功率最高,但发生子宫过强收缩、羊水粪染机率明显高于组和组(P<0.05)。结论晚期妊娠FFN阳性/Bishop<7分时,使用米索引产最安全有效,临床上可作为使用米索引产的指征。应用FFN测定结合Bishop评分,为临床确定使用米索晚期妊娠引产的安全性提供依据。Objective:To evaluate the reliability and effectiveness of term pregnancy induced labor by small dosage of Misoprostol using FFN determination and Bishop mark,and to study the indication of induced labor by Misoprostol in late trimester of pregnancy.Methods:104 cases that had no less than 40 weeks gestational period and had no contraindications of induced labor were randomly divided into three groups: groupⅠ(20 cases, FFN negative/Bishop<7 mark); groupⅡ(50 cases, FFN positive/Bishop<7 mark); group Ⅲ( FFN positive/Bishop≥7 mark). 25 μg of Misoprostol was put in vaginal posterior fornix, and the total quantity of Misoprostol, the successful rate of induced labor, labor process, the incidence of amniotic fluid feces contaminated and cesarean section rate were recorded and analyzed statistically.Results:GroupⅠ showed the lowest successful rate of induced labor, more Misoprostol using times, easy absonant contraction of uterine, prolonged latent period, and more oxytocin to strengthen uterine contraction. GroupⅡpresented higher successful rate of induced labor and lower incidences of the complications such as over intensity uterine contraction, over stimulus syndrome of uterus and amniotic fluid feces contaminated. Group Ⅲ had the highest successful rate of induced labor,but the incidences of over intensity uterine contraction and amniotic fluid feces contaminated were evidently higher than groupⅠand Ⅱ(P<0.05).Conclusions:The use of Misoprostol was the most safe at the time of FFN positive/Bishop<7 mark in late trimester of pregnancy, which could be used as the clinical indication of induced labor by Misoprostol in late trimester of pregnancy.Combining the FFN determination with Bishop mark could provide the evidence of reliability for the induced labor by Misoprostol in late trimester of pregnancy clinically.

关 键 词：纤维蛋白类/分析 米索前列醇/投药和剂量 妊娠末期 引产/标准 

分 类 号：R719.31[医药卫生—妇产科学]