口服米索前列醇溶液与欣普贝生用于妊娠期高血压促宫颈成熟的疗效对比  

Comparison oral misoprostol solution versus vaginal dinoprostone on promoting cervical ripening in patients with gestational hypertension

作　　者：张翠 金浩 蒋静静 田美玲 李思思 靳颖[1] Zhang Cui;Jin Hao;Jiang Jingjing(Department of Obstetrics and Gynecology,Hebei Jeneral Hospital,Shijiazhuang 050050;Department of Respiratory,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050032)

机构地区：[1]河北省人民医院妇产科,石家庄050050 [2]河北医科大学第四医院呼吸科,石家庄050032

出　　处：《现代妇产科进展》2023年第9期662-665,共4页Progress in Obstetrics and Gynecology

基　　金：2022年河北省医学科学研究课题计划(No:20221408)。

摘　　要：目的:探讨口服米索前列醇溶液和欣普贝生用于宫颈条件不成熟的妊娠期高血压孕妇引产的有效性和安全性。方法:回顾分析2022年10月至2023年5月河北省人民医院收治的63例需终止妊娠的宫颈评分<6分的妊娠期高血压孕妇,其中30例给予口服米索前列醇溶液促宫颈成熟,33例给予欣普贝生促宫颈成熟。收集并比较两组孕妇的产程、分娩方式、中转剖宫产率,以及产钳率、侧切率、产后出血率、转入新生儿监护病房等。结果:米索前列醇组的宫颈成熟时间和引产时间均长于欣普贝生组[(32.77±20.37)h vs (16.09±16.42)h,P=0.07;(39.15±28.21)h vs (11.57±8.56)h,P=0.019]。米索前列醇组和欣普贝生组24h内阴道分娩者分别是12.00%和84.44%,需联合其他引产方法者分别占43.33%和4.76%,差异均有统计学意义(P<0.001)。两者的产程、中转剖宫产率、产钳率、侧切率、产后出血率、新生儿入住新生儿监护病房等比较,差异无统计学意义(P>0.05)。与欣普贝生组比较,米索前列醇组因胎儿窘迫行剖宫产率显著降低(P=0.04,RR=0.25,95%CI为0.07~0.98),因可疑感染行剖宫产率显著升高(P=0.01,RR=3.01,95%CI为1.36~6.93),子宫过度刺激发生风险明显降低(P=0.001,RR为0.26,95%CI为0.08~0.74)。结论:妊娠期高血压孕妇需引产促宫颈成熟时,口服低剂量的米索前列醇溶液安全有效,但引产时间较长,24h内分娩率低,且需联合其他促宫颈成熟方法。Objective:To compare the efficacy and safety of induction of labor with oral misoprostol compared to vaginal dinoprostone in patients with gestational hypertension with an unripe cervix.Methods:A retrospective study was conducted on 63 patients with gestational hypertension admitted to Hebei Provincial People's Hospital from October 2022 to May 2023,who benefited from an induction of labor.Oral misoprostol solution or vaginal dinoprostone was given to promote cervical ripening when the cervical score was less than 6.Then collect clinical data of two groups of pregnant women.The safety and efficacy were compared with that of vaginal dinoprostone and oral misoprostol solution for induction of labor by analyzing the labor process,conversion rate to cesarean section,forceps rate,rate of episiotomy,postpartum hemorrhage,neonatal referral to the pediatrician.Results:The cervical ripening time and the induction to delivery time in the misoprostol group was significantly longer than those in the dinoprostone group[(32.77±20.37)h vs(16.09±16.42)h,P=0.07;(39.15±28.21)h vs(11.57±8.56)h,P=0.019].The proportion of vaginal delivery within 24 hours in the misoprostol group and dinoprostone group was 12.00%and 84.44%,and the proportion requiring combination with other induction methods was 43.33%and 4.76%,respectively,with statistically significant differences(P<0.001).There was no statistically significant difference between the two groups for the labor process,conversion rate of cesarean section,forceps rate,rate of episiotomy,postpartum hemorrhage rate,and newborns admission to NICU(P>0.05).However,the cesarean delivery rate of suspected fetal distress was higher in the dinoprostone group(P=0.04,RR=0.25,95%CI:0.07~0.98),the cesarean delivery rate of suspected infection was significantly increased(P=0.01,RR=3.01,95%CI:1.36~6.93),and the excessive uterine stimulation caused by oral misoprostol group was significantly reduced(P=0.001,RR=0.26,95%CI:0.08~0.74).Conclusions:Oral low doses of misoprostol solution is safe and effe

关 键 词：米索前列醇溶液 欣普贝生 引产 宫颈成熟 妊娠期高血压 

分 类 号：R714.7[医药卫生—妇产科学]