足月胎膜早破伴宫颈条件不佳：期待治疗、阴道使用前列腺素及缩宫素引产的比较
Premature rupture of membranes at term with an unfavorable cervix: comparison of expectant management, vaginal prostaglandin, and oxytocin induction.
作者信息
McCaul J F, Rogers L W, Perry K G, Martin R W, Allbert J R, Morrison J C
机构信息
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
出版信息
South Med J. 1997 Dec;90(12):1229-33. doi: 10.1097/00007611-199712000-00013.
BACKGROUND
Our objective was to determine the best treatment for parturients at term with an unfavorable cervix and premature rupture of membranes (PROM).
METHODS
In this prospective study, 96 women with PROM and an unfavorable cervix were randomized into one of three treatment groups: oxytocin induction, vaginal prostaglandin E2 gel followed by oxytocin, or expectant management.
RESULTS
Length of labor, cesarean section rate, and maternal/neonatal morbidity were not significantly different. In contrast, the interval from PROM until delivery and length of hospital stay were significantly longer in the expectantly managed group than in the other groups. Four of the patients who received expectant management required delivery because of nonreassuring fetal assessments.
CONCLUSIONS
Expectant management of PROM at term significantly prolongs hospital stay without decreasing the incidence of abdominal delivery or infectious morbidity. There appears to be potential for cord compression in patients managed expectantly without continuous electronic fetal surveillance.
背景
我们的目的是确定对于足月宫颈条件不佳且胎膜早破（PROM）的产妇的最佳治疗方法。
方法
在这项前瞻性研究中，96例胎膜早破且宫颈条件不佳的女性被随机分为三个治疗组之一：缩宫素引产、阴道用前列腺素E2凝胶后用缩宫素，或期待治疗。
结果
产程长度、剖宫产率及母婴发病率无显著差异。相比之下，期待治疗组从胎膜早破至分娩的间隔时间和住院时间显著长于其他组。接受期待治疗的4例患者因胎儿评估不乐观而需要分娩。
结论
足月胎膜早破的期待治疗显著延长住院时间，且不降低剖宫产率或感染发病率。对于未进行连续电子胎心监护而接受期待治疗的患者，似乎存在脐带受压的可能性。
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