促宫颈成熟和引产:2023年加拿大妇产科医师协会指南解读  

Cervical ripening and induction of labor: Interpretation of 2023 Society of Obstetricians and Gynaecologists of Canada clinical practice guideline

作　　者：杨丽菊 时春艳[1] Yang Liju;Shi Chunyan(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China;Department of Obstetrics and Gynecology,Affiliated Hospital of Yangzhou University,Yangzhou 225012,China)

机构地区：[1]北京大学第一医院妇产科,北京100034 [2]扬州大学附属医院妇产科,扬州225012

出　　处：《中华围产医学杂志》2023年第10期803-810,共8页Chinese Journal of Perinatal Medicine

摘　　要：2023年加拿大妇产科医师协会(Society of Obstetricians and Gynaecologists of Canada,SOGC)根据最新的研究结果及循证证据发布了促宫颈成熟和引产指南,该指南分为引产总则、促宫颈成熟和引产三部分,详述了促宫颈成熟和引产的指征和方法。本文就该指南中主要的更新点进行重点解读。该指南重点强调了引产的个体化,更强调了尊重患者选择的人文关怀;建议孕8~12周应用超声核对孕周,提出40岁及以上孕妇≥39周引产的合理性,不建议无指征的意愿选择性引产;在促宫颈成熟方面,球囊和前列腺素制剂同样有效,球囊可用于瘢痕子宫要求阴道分娩者,球囊及前列腺素E2栓剂可用于门诊促宫颈成熟;米索前列醇和前列腺素E2制剂既可用于促宫颈成熟又可用于宫缩诱导剂引产。小剂量米索前列醇口服安全有效,米索前列醇溶液更易于精准给药。若促宫颈成熟时间较长,在母胎安全的情况下,促宫颈成熟过程可以中断休息后再开始。In January 2023,the Society of Obstetricians and Gynaecologists of Canada(SOGC)released the guidelines"Cervical Ripening and Induction of Labour"based on the latest research results and evidence-based evidence,which are divided into three parts:General,Cervical Ripening and Induction of Labour,detailing the indications and methods of cervical ripening and induction of labor.This article highlights the main update points in the guideline.The SOGC Induction Guideline emphasizes the individualization of induction and the importance of respecting patients'choices and providing humane care.The guideline also recommends to confirm gestational age according to the ultrasound examination at 8-12 weeks and inducing labor for pregnant women aged 40 and above at or after 39 weeks.In terms of cervical ripening,both balloon catheters and prostaglandin preparations are effective,with balloon catheters being suitable for women with scarred uterus who require vaginal delivery.Balloon catheters and prostaglandin E2 suppositories can be used for outpatient cervical ripening.Misoprostol and prostaglandin E2 preparations can be used for both cervical ripening and labor induction.Low-dose oral misoprostol is safe and effective,while misoprostol solution is easier to administer accurately.If cervical ripening is prolonged,the process of cervical ripening can be interrupted if the mother and fetus are safe.

关 键 词：宫颈成熟 引产 诊疗指南 

分 类 号：R719.3[医药卫生—妇产科学]