Blair F C, Tassone S A, Pearman C R, St Cyr M B, Rayburn W F
Department of Obstetrics and Gynecology, Columbia Presbyterian Hospital, Oklahoma City, Oklahoma, USA.
J Reprod Med. 1998 May;43(5):408-12.
To determine the safety of initiating labor using a sustained-release prostaglandin E2 (PGE2) vaginal insert at a nonuniversity-based community hospital.
Data were compiled from a chart review of all cases in which the insert (Cervidil) was used during a 16-month period. Continuous uterine activity and fetal heart rate (FHR) tracings were evaluated for 12 hours after dosing. The onset of regular uterine contractions or of active labor and the reason for any premature removal of the insert were sought.
Regular contractions ensued in 62 (35.8%) of 173 pregnancies. Primary reasons for removal of the insert in 59 (34.1%) cases were active labor (38), ruptured membranes (11), uterine hyperstimulation (7) and a nonreassuring FHR tracing. The average time from insertion until premature removal was 5.7 +/- 1.3 (SD) hours (95% confidence interval, 3.3-8.2). The insert fell out in nine (5.2%) cases. Cesarean delivery for failed labor induction was necessary in five (2.9%) cases. All immediate neonatal outcomes were reassuring. Following inservice training, nurses were capable of inserting and removing the insert.
This PGE2 vaginal insert, administered and removed by attending nurses, is associated with very low rates of uterine hyperstimulation and failed induction. Premature removal of the insert occurred in 34.1% of cases.
确定在一家非大学附属医院使用缓释前列腺素E2（PGE2）阴道栓剂引产的安全性。
通过回顾16个月期间所有使用该栓剂（欣普贝生）的病例资料进行分析。给药后12小时评估子宫持续活动情况及胎儿心率（FHR）描记图。寻找规律子宫收缩或活跃产程的开始情况以及栓剂过早取出的原因。
173例妊娠中有62例（35.8%）出现规律宫缩。59例（34.1%）病例中栓剂取出的主要原因是活跃产程（38例）、胎膜破裂（11例）、子宫过度刺激（7例）及FHR描记图异常。从插入到过早取出的平均时间为5.7±1.3（标准差）小时（95%置信区间，3.3 - 8.2）。9例（5.2%）栓剂自行脱落。5例（2.9%）病例因引产失败而行剖宫产。所有新生儿即时结局均良好。在职培训后，护士能够插入和取出该栓剂。
由值班护士给药和取出的这种PGE2阴道栓剂，子宫过度刺激和引产失败的发生率很低。34.1%的病例出现栓剂过早取出的情况。
