Margono F, Minkoff H, Chan E
Department of Obstetrics and Gynecology, State University of New York Health Science Center, Brooklyn.
Obstet Gynecol. 1993 Apr;81(4):481-5.
To determine the gradient of pressure between the upper and the lower uterine segments of parturients with non-progressing labor and to see whether the gradient correlates with subsequent successful oxytocin augmentation.
Fifteen women with active-phase arrest of labor were monitored with two intrauterine pressure transducers before and after oxytocin augmentation. Seven parturients without arrest of labor were evaluated for comparison. One intrauterine pressure transducer was inserted into the upper and one into the lower uterine segment of each subject. Overall, 444 contractions were assessed using the mean active pressure method.
A total of 16 patients delivered vaginally. Nine received oxytocin augmentation, and all had significantly higher pressure in the upper segment than in the lower both before and after oxytocin (P < .001). Six women delivered by cesarean had a reversed gradient of uterine activity, with the lower segment contracting significantly more strongly than the upper uterine segment both before (P = .002) and after oxytocin (P = .001).
Pressure gradients between the upper and lower uterine segments in the active phase might predict the likelihood of success of oxytocin augmentation.
确定产程无进展的产妇子宫上下段之间的压力梯度，并观察该梯度是否与随后缩宫素增强宫缩的成功与否相关。
对15例活跃期产程停滞的产妇在缩宫素增强宫缩前后使用两个宫内压力换能器进行监测。评估7例未发生产程停滞的产妇作为对照。为每位受试者在上段子宫和下段子宫各插入一个宫内压力换能器。总体上，采用平均有效压力法评估了444次宫缩。
共有16例患者经阴道分娩。9例接受了缩宫素增强宫缩，且在使用缩宫素前后，所有患者上段子宫的压力均显著高于下段子宫（P < .001）。6例行剖宫产的产妇子宫活动梯度相反，在使用缩宫素前（P = .002）和使用缩宫素后（P = .001），下段子宫收缩均明显强于上段子宫。
活跃期子宫上下段之间的压力梯度可能预测缩宫素增强宫缩成功的可能性。
