摘要
目的探讨足月经产妇使用地诺前列酮栓促宫颈成熟的置药特点、引产特征和安全性,以指导其临床应用。方法回顾性分析首都医科大学附属北京世纪坛医院产科2019年1~10月收治的237例Bishop评分≤6分、阴道放置地诺前列酮栓促宫颈成熟的足月妊娠孕妇资料,其中经产妇34例,初产妇203例,比较两组产妇的置药时长、取药原因、用药至临产时长、产程时间、临产时间、产后出血量、新生儿Apgar评分、胎儿窘迫、新生儿窒息、药物不良反应等情况。结果经产妇组置药时长较初产妇组缩短[(5.78±3.85)h vs(8.54±5.82)h],差异有统计学意义(P<0.05)。经产妇因宫颈条件改善取药的占比大于初产妇,经产妇用药至临产时长[(4.75±7.78)h vs(11.38±13.80)h]、产程时间[(4.24±1.06)h vs(8.19±5.41)h]均小于初产妇,差异有统计学意义(P<0.05)。经产妇24 h内临产率为94.12%,初产妇为77.34%,差异有统计学意义(P<0.05)。两组产后出血、胎儿宫内窘迫发生率、新生儿窒息率、新生儿1 min Apgar评分、药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论足月经产妇使用地诺前列酮栓促宫颈成熟安全、有效。临床操作中应严密观察宫颈变化及宫缩情况并及时取药,密切关注产程进展,加强不良反应监测。
Objective To explore the characteristics of drug placement,labor induction and safety of dinoprostone suppositories used in full-term multipara to promote cervical ripening to guide its clinical application.Methods A retrospective analysis of the data of 237 full-term pregnant women with Bishop score≤6 and vaginal placement of dinoprostone suppository to promote cervical ripening,admitted to Department of Obstetrics,Beijing Shijitan Hospital,Capital Medical University,from January to October 2019.Among them,there were 34 cases of multipara and 203 cases of unipara.Compared the length of time of drug placement,reasons for taking out drug,the length of time from placing drug to labor starting,labor time,parturient time,postpartum hemorrhage,Apgar score,fetal distress rate,neonatal asphyxia rate,and adverse drug reactions condition.Results The time of drug placement in the multipara group was shorter than that in the primipara group[(5.78±3.85)h vs(8.54±5.82)h],the difference was statistically significant(P<0.05).The proportion of women who took out medicines due to improved cervical conditions was greater than that of primiparous women.The time from medication to labor[(4.75±7.78)h vs(11.38±13.80)h]and time of labor[(4.24±1.06)h vs(8.19±5.41)h]were smaller than primiparous women,the differences were statistically significant(P<0.05).The parturient rate within 24 hours of multipara was 94.12%and 77.34%for primiparous women,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of postpartum hemorrhage,intrauterine distress,neonatal asphyxia,neonatal 1 min Apgar score,and adverse drug reactions between the two groups(P>0.05).Conclusion It is safe and effective to use dinoprostone suppository for full-term multipara to promote cervical ripening.During clinical operation,cervical changes and uterine contractions should be closely observed and medicines should be taken in time,pay close attention to the progress of labor,and strengthen the monitoring of adverse reactions.
作者
马晓玮
屠京慧
MA Xiaowei;TU Jinghui(Department of Pharmacy,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use,Capital Medical University,Beijing 100038,China;International Cooperation&Joint Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use,Capital Medical University,Beijing 100038,China;Department of Obstetrics,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《中国计划生育和妇产科》
2021年第2期56-59,82,共5页
Chinese Journal of Family Planning & Gynecotokology
基金
临床合理用药生物特征谱学评价北京市重点实验室建设经费(项目编号:BZ0439)
北京市优秀人才项目(项目编号:2018000021223TD09)。
关键词
地诺前列酮栓
足月妊娠
经产妇
促宫颈成熟
引产
dinoprostone suppository
full-term pregnancy
multipara
promoting cervical ripening
induction of labor
