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[宫颈内给予前列腺素E2凝胶联合β-拟交感神经药后催产素(OT)和13,14-二氢-15-酮-前列腺素F2α(PGFM)水平;生化变化及临床后果]

[Oxytocin (OT) and 13,14-dihydro-15-keto-PGF2 alpha (PGFM) levels after intracervical administration of PGE2 gel combined with administration of beta mimetics; biochemical changes and clinical consequences].

作者信息

Goeschen K, Fuchs A R, Rasmussen A B, Fuchs F, Saling E

出版信息

Geburtshilfe Frauenheilkd. 1983 Oct;43(10):589-93. doi: 10.1055/s-2008-1036717.

DOI:10.1055/s-2008-1036717
PMID:6557966
Abstract

Intracervical application of 0.4 mg PGE2 gel for achieving maturity of the cervix before necessary inducement of labour results in 1-2% of the cases in permanent contractions in association with foetal bradycardias (Goeschen and Saling, 6). This Complication can be removed by the administration of the beta-mimetic Fenoterol given by the intravenous route. Basing on this fact we tried to find out whether it would be possible to prevent an increase in labour activity by administering Fenoterol before applying PGE2 without impairing the softening effect, and also how the OT and PGFM concentrations in the plasma are affected. To clarify this, we compared the clinical and biochemical results obtained in 5 patients who had been given 5 mg Fenoterol orally before receiving 0.4 mg PGE2 gel, with the results obtained in patients who had been treated without any previous Fenoterol administration with either 0.4 mg PGE2 (n = 10), 0.8 mg PGE2 (n = 6) or placebo gel (n = 5). In all groups treated with the preparation were obtained significant differences compared with the placebo group in respect of maturation of the cervix. Oral administration of Fenoterol did not produce any weaking of the softening effect; an increase of the dose to 0.8 mg did not result in an enhancement. After intracervical administration of 0.4 mg PGE2 gel the PGFM values remained unchanged with and without Fenoterol administration; the same was true also after 0.8 mg PGE2 and after placebo. As with spontaneous labour, a significant PGFM increase was seen only if the cervical diameter had attained 7 cm or more.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在必要的引产之前,宫颈内应用0.4毫克前列腺素E2凝胶以促使宫颈成熟,会导致1%-2%的病例出现持续性宫缩并伴有胎儿心动过缓(戈申和萨林,6)。这种并发症可通过静脉注射β-拟交感神经药非诺特罗来消除。基于这一事实,我们试图弄清楚在应用前列腺素E2之前给予非诺特罗是否有可能在不损害软化效果的情况下预防宫缩活动增加,以及血浆中催产素(OT)和13,14-二氢-15-酮前列腺素F2α(PGFM)浓度会受到怎样的影响。为了阐明这一点,我们将5名在接受0.4毫克前列腺素E2凝胶之前口服5毫克非诺特罗的患者所获得的临床和生化结果,与那些未预先给予非诺特罗而接受0.4毫克前列腺素E2(n = 10)、0.8毫克前列腺素E2(n = 6)或安慰剂凝胶(n = 5)治疗的患者的结果进行了比较。与安慰剂组相比,所有接受该制剂治疗的组在宫颈成熟方面均有显著差异。口服非诺特罗并未使软化效果减弱;剂量增加到0.8毫克也未导致增强效果。在宫颈内给予0.4毫克前列腺素E2凝胶后,无论是否给予非诺特罗,PGFM值均保持不变;给予0.8毫克前列腺素E2后以及给予安慰剂后情况也是如此。与自然分娩一样,只有当宫颈直径达到7厘米或更大时,才会出现PGFM显著增加。(摘要截取自250词)

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