Chanrachakul B, Suthutvoravut S, Sangthawan M, Herabutya Y
Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2001 Nov;84(11):1582-6.
Previous studies have shown that sweeping between the membranes and lower uterine segment was an effective procedure for reducing prolonged pregnancy. However, there has been no study to show the effect of lower uterine segment sweeping to the progress of the active phase of labor. This study was to determine the effect of lower uterine segment sweeping on the progress of the active phase of labor in nullipara. A total of four hundred nulliparous term pregnant women with spontaneous labor were randomized to one of two groups; the control group had routine vaginal examination while the study group had lower uterine segment sweeping at the time of each examination. Oxytocin infusion was given if there was dysfunctional labor. Progression of labor and the need for oxytocin augmentation were reviewed. Data were analyzed by chi square and Student t-test. Oxytocin was used in 67 per cent of the sweeping group and 62 per cent of the control group (p=0.3). The duration of the first stage (0.46), the second stage (0.38), and the third stage (0.28) of labor were not significantly different between the two groups. In conclusion, lower uterine segment sweeping did not reduce the need for oxytocin augmentation or lessen the duration of labor in nullipara.
以往研究表明，在胎膜与子宫下段之间进行扫刮是减少过期妊娠的有效方法。然而，尚无研究表明子宫下段扫刮对产程活跃期进展的影响。本研究旨在确定子宫下段扫刮对初产妇产程活跃期进展的影响。共有400例自然临产的初产妇被随机分为两组；对照组进行常规阴道检查，而研究组在每次检查时进行子宫下段扫刮。如果出现产程异常则给予催产素静脉滴注。回顾产程进展及催产素加强宫缩的需求情况。数据采用卡方检验和学生t检验进行分析。扫刮组67%的产妇和对照组62%的产妇使用了催产素（p = 0.3）。两组之间第一产程（0.46）、第二产程（0.38）和第三产程（0.28）的时长无显著差异。总之，子宫下段扫刮并不能减少初产妇对催产素加强宫缩的需求，也不能缩短产程。
