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比较产道内局部应用PGE_2凝胶与静脉滴注催产素促宫颈成熟及引产效果。将100例单胎、头位、足月妊娠的初产妇随机分为两组,每组各50例。一组于宫颈管内或阴道后穹隆局部应用PGE_2凝胶—PDE_2组,一组用静脉滴注催产素作为对照组。结果:PGE_2组用药12h后促宫颈成熟,32h引产成功率均为96.0％,明显高于对照组。阴道自然分娩率84.0％(对照组66.0％,χ~2=4.32,P<0.05)。用药到分娩发动时间平均为15.3±9.1h[对照组(27.3±15.2)h,P<0.01]。平均总产程为5.6±0.8h[对照组为(8.4±3.5)h,P<0.005]。剖宫产率10.0％,明显低于对照组的24.0％(P<0.01)。两组间产后出血及新生儿出生体重差异无显著性。结果证明:PGE_2凝胶用于引产是一种安全、可靠的方法。并对PGE_2凝胶促宫颈成熟的机理进行了探讨。
Comparison of local application of PGE 2 gels and intravenous infusion of oxytocin to promote cervical ripening and induction of labor. 100 cases of singleton, head, full-term pregnancy primiparas were randomly divided into two groups, 50 cases in each group. A group of PGE 2 gel-PDE 2 groups were applied locally in the cervical canal or vaginal posterior fornix. One group was given intravenous oxytocin as control group. RESULTS: The cervix matured in PGE_2 group after 12 hours, and the successful rate of induction of labor in 32 hours was 96.0%, which was significantly higher than that in control group. Vaginal natural delivery rate of 84.0% (66.0% in the control group, χ ~ 2 = 4.32, P <0.05). The mean time from initiation of medication to delivery was 15.3 ± 9.1 h [control group (27.3 ± 15.2 h, P <0.01]. The average duration of labor was 5.6 ± 0.8 h [control group (8.4 ± 3.5) h, P <0.005]. Cesarean section rate was 10.0%, which was significantly lower than that of the control group (24.0%, P <0.01). There was no significant difference in postpartum hemorrhage and newborn birth weight between the two groups. The results show that: PGE_2 gel for induction of labor is a safe and reliable method. The mechanism of cervical ripening promoted by PGE_2 gel was also discussed.