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米索前列醇与缩宫素用于过期妊娠引产术后子宫及胎儿多普勒血流变化

Uterine and fetal Doppler flow changes after misoprostol and oxytocin therapy for induction of labor in post-term pregnancies.

作者信息

Lemancewicz A, Urban R, Skotnicki M Z, Karpiuk A, Urban J

机构信息

Department of Perinatology, Bialystok Medical School, Poland.

出版信息

Int J Gynaecol Obstet. 1999 Dec;67(3):139-45. doi: 10.1016/s0020-7292(99)00160-5.

Abstract

OBJECTIVES

To compare the effect of misoprostol vs. oxytocin on blood flow in uteroplacental circulation during labor induction.

METHODS

Ninety-one women with indications for induction of labor were assigned to receive either misoprostol 50 microg per vagina every 4 h as needed or intravenous oxytocin by means of a randomization table generated by computer. Doppler velocimetry of umbilical, uterine and arcuate arteries was performed immediately before and 2-3 h after administration of misoprostol or oxytocin. Pulsatility index (PI), resistance index (RI) and systolic/diastolic (S/D) ratios were measured for these arteries. The SAS system was used to perform statistical analysis.

RESULTS

There were no significant changes of PI, RI and S/D ratios in umbilical arteries during misoprostol and oxytocin inductions. Vaginal application of misoprostol significantly increased PI, RI and S/D ratios in arcuate arteries and S/D ratio in uterine arteries.

CONCLUSIONS

Our results indicate that intravaginal misoprostol administration increases uteroplacental resistance but probably does not substantially affect placental perfusion.

摘要

目的

比较米索前列醇与缩宫素在引产过程中对子宫胎盘循环血流的影响。

方法

91例有引产指征的妇女通过计算机生成的随机表被分配接受按需每4小时经阴道给予50微克米索前列醇或静脉滴注缩宫素。在给予米索前列醇或缩宫素之前及给药后2 - 3小时立即进行脐动脉、子宫动脉和弓状动脉的多普勒测速。测量这些动脉的搏动指数(PI)、阻力指数(RI)和收缩/舒张(S/D)比值。使用SAS系统进行统计分析。

结果

在米索前列醇和缩宫素引产过程中,脐动脉的PI、RI和S/D比值无显著变化。经阴道应用米索前列醇显著增加了弓状动脉的PI、RI和S/D比值以及子宫动脉的S/D比值。

结论

我们的结果表明,经阴道给予米索前列醇会增加子宫胎盘阻力,但可能不会对胎盘灌注产生实质性影响。

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