Horenstein J M, Eglinton G S, Tahilramaney M P, Boucher M, Phelan J P
J Reprod Med. 1984 Jan;29(1):26-30.
In patients who have had a previous cesarean section (C/S), the use of oxytocin during a trial of labor (TOL) remains controversial. In order to better delineate the risks associated with oxytocin usage in patients with prior C/S undergoing a TOL, a retrospective investigation was undertaken. During the study period, January 1 to December 31, 1980, 308 previous-C/S patients underwent a TOL. Oxytocin was used on 58 (18.8%) for either labor induction (12) or augmentation (46). Vaginal delivery was accomplished in 31 (53.4%) of the patients who received oxytocin. Vaginal delivery was accomplished in 196 (83.8%) of the 292 patients who labored spontaneously. Patients who had no vaginal deliveries after previous C/S and required oxytocin were at a significantly increased risk of undergoing C/S. There was no statistically significant difference between the oxytocin vs. nonoxytocin groups with regard to instruments used in vaginal delivery, uterine scar dehiscence, transfusions, birth trauma or neonatal outcome. In patients with a previous C/S who undergo a TOL, the use of oxytocin in a judicious manner appears to be safe. However, additional studies are required to corroborate this conclusion.
对于有剖宫产史的患者，在引产试验（TOL）期间使用缩宫素仍存在争议。为了更好地描述有剖宫产史的患者在引产试验中使用缩宫素相关的风险，进行了一项回顾性调查。在1980年1月1日至12月31日的研究期间，308例有剖宫产史的患者进行了引产试验。58例（18.8%）患者使用了缩宫素，其中12例用于引产，46例用于加强宫缩。接受缩宫素治疗的患者中有31例（53.4%）经阴道分娩。292例自然分娩的患者中有196例（83.8%）经阴道分娩。有剖宫产史且未自然分娩而需要使用缩宫素的患者行剖宫产的风险显著增加。在阴道分娩所使用的器械、子宫瘢痕裂开、输血、产伤或新生儿结局方面，缩宫素组与未使用缩宫素组之间无统计学显著差异。对于有剖宫产史且进行引产试验的患者，谨慎使用缩宫素似乎是安全的。然而，需要更多研究来证实这一结论。
