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[与宫颈状态相关的使用前列腺素E2进行宫颈成熟度调整的引产术后胎儿结局。一项多中心研究的结果]

[Fetal outcome after cervical ripeness-adjusted labor induction with prostaglandin E2 in relation to cervix status. Results of a multicenter study].

作者信息

Bredow V, Straube W

机构信息

Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Medizinischen Fakultät, Ernst-Moritz-Arndt-Universität Greifswald.

出版信息

Zentralbl Gynakol. 1993;115(12):530-6.

PMID:8147164
Abstract

Prostaglandin E2 is often used for induction of labour. A procedure appropriate for obstetrical condition of the cervix uteri is recommended. 1,472 births with a medical indication were induced in a multicenter-study. With a bishopscore < 5 prostaglandin E2 gel intracervical and with a score between 5 and 8 vaginal tablets were used for induction. Appropriate for the condition of cervix it was allowed to continue the induction. With a bishopscore > 8 an infusion of oxytocin was given. The fetal outcome was evaluated appropriate for the condition of cervix before and during induction of labour. The APGAR-score one minute post partum was < 8 in 10.8 per cent of all neonates. This part was near the same in the gel- and in the tablet group (p > 5%). By continuation of induction, the part with pathological findings was at all times not in relation to the different groups of cervical condition. It's the same by APGAR-scores 5 and 10 minutes after delivery. The acidotic morbidity at all was 10.7%. Also in this connection it was only an unimportant (p > 5%) increasing to observe then the induction was continued. There is no relation between the different groups of cervical condition and the acidotic morbidity. Under observation of mother and child the to cervical condition appropriated used method of induction of labour does not expect a bad neonatal outcome. The longer the cervix is unripen, the higher is the rate of delivery by caesarean section. The exploitation of the possibilities of induction by drugs can be recommended.

摘要

前列腺素E2常用于引产。推荐采用适合子宫颈产科状况的方法。在一项多中心研究中,对1472例有医学指征的分娩进行了引产。当Bishop评分<5时,采用宫颈内注射前列腺素E2凝胶;当评分在5至8之间时,使用阴道片进行引产。根据宫颈状况,允许继续引产。当Bishop评分>8时,给予催产素静脉滴注。在引产前后,根据宫颈状况对胎儿结局进行评估。所有新生儿中,产后1分钟Apgar评分<8的占10.8%。凝胶组和片剂组的这一比例相近(p>5%)。继续引产时,有病理发现的比例在任何时候都与不同宫颈状况组无关。分娩后5分钟和10分钟的Apgar评分情况也是如此。酸中毒发病率总体为10.7%。在这方面,继续引产时也仅观察到一个不重要的(p>5%)增加。不同宫颈状况组与酸中毒发病率之间没有关联。在观察母婴的情况下,根据宫颈状况采用合适的引产方法不会导致不良的新生儿结局。宫颈未成熟的时间越长,剖宫产率越高。推荐利用药物引产的可能性。

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