Nesse R E
Prim Care. 1983 Jun;10(2):253-67.
The management of labor is based on a sound understanding of labor's biochemistry and physiology. The interaction between prostaglandin synthesis and other mechanisms postulated to control the initiation of labor shows promise, but the definitive explanation for the initiation of labor awaits further research. The procedures associated with the management of routine labor, including perineal preparation and the use of enemas, intravenous fluids, and analgesics and anesthetics, are generally best applied on the basis of individual need rather than protocol. The Friedman labor curve and intrapartum risk scoring have proved to be useful indices in the evaluation of the course of labor. Oxytocin and prostaglandin are two clinically useful agents in the induction and augmentation of labor. Currently, prostaglandin is used generally in the induction of preterm labors with oxytocin reserved for the induction of labor at term. The effects and side effects of the medications may be controlled by careful use and monitoring. A protocol for the successful use of oxytocin includes careful fetal monitoring and control of intravenous infusion with careful incremental increases in the dose of oxytocin based on uterine response.
产程管理基于对产程生物化学和生理学的充分理解。前列腺素合成与其他假定用于控制分娩发动的机制之间的相互作用显示出前景，但分娩发动的确切解释仍有待进一步研究。与常规产程管理相关的程序，包括会阴准备以及灌肠剂、静脉输液、镇痛药和麻醉药的使用，通常最好根据个体需求而非规程来应用。弗里德曼产程曲线和产时风险评分已被证明是评估产程进展的有用指标。缩宫素和前列腺素是临床上用于引产和加强宫缩的两种药物。目前，前列腺素一般用于引产早产，缩宫素则留作足月引产。通过谨慎使用和监测，可以控制药物的效果和副作用。成功使用缩宫素的规程包括仔细的胎儿监测和静脉输液控制，根据子宫反应谨慎逐步增加缩宫素剂量。
