Gupta R, Vasishta K, Sawhney H, Ray P
Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Gynaecol Obstet. 1998 Feb;60(2):115-21. doi: 10.1016/s0020-7292(97)00249-x.
To assess the efficacy of stripping of membranes in initiation of labor and to study its effect on maternal and perinatal morbidity.
One-hundred primigravidae with certain gestational dates were randomized at 38 weeks gestation to either receive stripping of membranes or only gentle cervical examination. Cervical swabs were taken before pelvic examination at 38 weeks and again at the onset of labor. Placental membranes were sent for bacteriological study after delivery in all patients.
The mean gestational age, parity and Bishop score were similar in both groups at recruitment. Gestational age at delivery was lower in the study group (38.70 +/- 0.63) compared to the control group. Seventy-two percent of the study group and 8% of the control group had spontaneous onset of labor within 7 days of examination. Labor was induced in one patient (2%) of the study group and 16 patients (32%) of the control group. No statistically significant difference was noted in incidence of premature rupture of membranes (PROM), mode of delivery, intrapartum events and perinatal outcome. No increase in neonatal morbidity was seen in association with this procedure. No patient in the study group had clinical evidence of chorioamnionitis. There was no statistically significant difference in the microbiological flora of both groups.
Stripping of the fetal membranes is a safe and efficacious procedure for induction of labor. It decreases the incidence of induction of labor with no increase in incidence of maternal and neonatal morbidity.
评估剥膜术在引产中的疗效，并研究其对孕产妇及围产儿发病率的影响。
100例孕周确定的初产妇在妊娠38周时随机分组，一组接受剥膜术，另一组仅接受轻柔的宫颈检查。在妊娠38周进行盆腔检查前及临产时分别采集宫颈拭子。所有患者分娩后将胎盘胎膜送去做细菌学研究。
两组入组时的平均孕周、产次及 Bishop 评分相似。研究组的分娩孕周低于对照组（38.70±0.63）。研究组72%的患者及对照组8%的患者在检查后7天内自然临产。研究组1例患者（2%）及对照组16例患者（32%）需要引产。胎膜早破（PROM）的发生率、分娩方式、产时情况及围产儿结局方面未观察到统计学上的显著差异。该操作未导致新生儿发病率增加。研究组中无患者有绒毛膜羊膜炎的临床证据。两组的微生物菌群无统计学上的显著差异。
剥膜术是一种安全有效的引产方法。它降低了引产的发生率，且未增加孕产妇及新生儿发病率。
