Rayburn William F
Department of Obstetrics and Gynecology, School of Medicine, University of New Mexico, 2211 Lomas Boulevard NE, Albuquerque, NM 87131-5286, USA.
Obstet Gynecol Surv. 2002 Oct;57(10):683-92. doi: 10.1097/00006254-200210000-00022.
The rate of women undergoing labor induction is increasing, primarily because of patient-physician preferences. The widespread availability of preinduction cervical ripening agents has contributed to this rising trend. Approximately half of all women undergoing an induction of labor will have an unfavorable cervix that will require some ripening agent. Pharmacologic and mechanical dilator techniques have been proven to ripen the unfavorable cervix. A topically applied prostaglandin product, containing either dinoprostone or misoprostol, is the most popular means to soften and dilate the cervix. Any uterine hyperstimulation may be reversed by administering a tocolytic drug and, if possible, by removal of the ripening agent. A minimum trial of adequate labor is necessary before considering the induction to be a failure. Cesarean delivery rates may be higher and the length of hospital stay more prolonged. Careful consideration about the need for labor induction is recommended until prospective clinical trials can better validate marginal reasons for cervical ripening.
接受引产的女性比例正在上升，主要是由于患者和医生的偏好。引产术前宫颈成熟剂的广泛可得性促成了这一上升趋势。所有接受引产的女性中，约有一半的宫颈条件不佳，需要使用某种成熟剂。药理学和机械扩张技术已被证明可使条件不佳的宫颈成熟。局部应用的前列腺素产品，含地诺前列酮或米索前列醇，是软化和扩张宫颈最常用的方法。通过使用宫缩抑制剂，如有可能，移除成熟剂，可逆转任何子宫过度刺激。在认定引产失败之前，必须进行充分的试产。剖宫产率可能更高，住院时间可能更长。在前瞻性临床试验能够更好地验证宫颈成熟的边缘性原因之前，建议仔细考虑引产的必要性。
