Löfgren M, Bäckström T
Department of Obstetrics and Gynecology, University of Umeå, Sweden.
Obstet Gynecol. 1992 May;79(5 ( Pt 1)):752-9.
Concentrations of progesterone and estradiol (E2) were measured in parturient serum and in fetal cord serum during normal labor and in women with functional dystocia. In the study group, there were no cases of cephalopelvic disproportion. In oxytocin-resistant dystocia, the course of labor could not be corrected with oxytocin. To ascertain the effect of oxytocin, we included a number of women whose labor had been induced with oxytocin, followed by normal cervical dilatation and descent of the fetus. All the parturients were grouped retrospectively into those with normal labor and those with dystocia, based on previous definitions. The serum concentrations of progesterone in both the fetal cord and maternal vein were found to be significantly lower in the oxytocin-resistant dystocia group than in women in spontaneous normal labor and those with oxytocin-induced labor and normal progression (P less than .05-.005). Oxytocin had no evident effect on the serum concentration of either progesterone or E2, nor did concentrations vary following epidural blockade. Serum E2 concentrations in the maternal vein were similar in all delivery groups. Fetal cord E2 serum concentrations were similar in all vaginal deliveries. Women with the most severe oxytocin-resistant dystocia, delivered by cesarean, had significantly lower serum concentrations of E2 in fetal cord serum compared with the vaginally delivered women (P less than .001).
在正常分娩以及功能性难产的产妇血清和胎儿脐带血清中测量了孕酮和雌二醇(E2)的浓度。研究组中没有头盆不称的病例。在对催产素抵抗的难产中,使用催产素无法纠正产程。为了确定催产素的作用,我们纳入了一些使用催产素引产随后宫颈正常扩张和胎儿下降的女性。根据先前的定义,所有产妇回顾性地分为正常分娩组和难产组。发现在对催产素抵抗的难产组中,胎儿脐带和母体静脉中的孕酮血清浓度显著低于自然正常分娩的女性以及催产素引产且产程正常进展的女性(P小于0.05 - 0.005)。催产素对孕酮或E2的血清浓度没有明显影响,硬膜外阻滞后浓度也没有变化。所有分娩组中母体静脉中的血清E2浓度相似。所有阴道分娩中胎儿脐带E2血清浓度相似。与阴道分娩的女性相比,剖宫产分娩的对催产素抵抗最严重的难产女性胎儿脐带血清中的E2血清浓度显著更低(P小于0.001)。