Mercer B, Pilgrim P, Sibai B
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
Obstet Gynecol. 1991 May;77(5):659-63.
One hundred twenty-three women were randomized to receive either of two regimens of oxytocin for labor induction. Sixty-one received a low-dose regimen, with oxytocin increases at intervals of not less than 60 minutes. Patients with unripe cervices received prolonged low-dose oxytocin priming before membrane rupture. Sixty-two others received a traditional protocol, with oxytocin increased every 20 minutes as required. Both groups had amniotomy when deemed safe and feasible. Oxytocin was adjusted for uterine hyperstimulation or abnormal fetal heart rate patterns in 29 and 58% of low-dose and traditional protocol subjects, respectively (P less than .001, odds ratio 3.6). No significant increase in time to delivery was seen with low-dose oxytocin infusion. Cesarean delivery and cesareans for fetal distress were more frequent in the traditional protocol group. This study demonstrates that a continuous low-dose protocol for oxytocin induction of labor is effective in establishing active labor and achieving vaginal delivery in women with both ripe and unripe cervices. It is also associated with fewer episodes of uterine hyperstimulation requiring adjustments of oxytocin infusion than is the traditional protocol of this institution.
123名妇女被随机分配接受两种催产素引产方案中的一种。61名接受低剂量方案，催产素每隔不少于60分钟增加一次。宫颈未成熟的患者在胎膜破裂前接受延长的低剂量催产素预处理。另外62名接受传统方案，根据需要每20分钟增加一次催产素。两组在认为安全可行时均进行人工破膜。分别有29%和58%的低剂量组和传统方案组患者因子宫过度刺激或异常胎心率模式而调整催产素剂量（P<0.001，优势比3.6）。低剂量催产素输注并未使分娩时间显著增加。传统方案组剖宫产及因胎儿窘迫行剖宫产的情况更为常见。本研究表明，持续低剂量催产素引产方案在促使宫颈成熟和未成熟的妇女进入活跃期分娩及实现阴道分娩方面是有效的。与本机构的传统方案相比，该方案还减少了因子宫过度刺激而需要调整催产素输注的情况。
