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目的为低宫颈评分的足月妊娠引产提供更适宜的方法。方法将187例具备引产指征的低宫颈评分(≤6分)足月妊娠产妇随机分组,其中宫颈扩张棒组(Ⅰ组)71例,催产素组(Ⅱ组)33例,米索前列醇组(Ⅲ组)35例,普贝生组(Ⅳ组)48例,比较各组产妇的促宫颈成熟有效率、引产至分娩的时间、计划分娩成功率、分娩方式及母婴并发症等情况。结果Ⅰ组促宫颈成熟有效70例(99%)、Ⅱ组有效5例(15%)、Ⅲ组32例(91%)、Ⅳ组有效45例(95%),Ⅰ、Ⅲ、Ⅳ三组与Ⅱ组相比,差异有统计学意义(P<0.05)。Ⅲ、Ⅳ组引产至分娩时间短于Ⅰ、Ⅱ组;Ⅳ组所需时间最短,Ⅱ组所需时间最长。四组总产程时间相当。Ⅰ组计划分娩成功率最高(84%),其他三组计划分娩成功率较低(Ⅱ、Ⅲ、Ⅳ组分别是15%、23%和27%)。Ⅰ组经阴分娩率最高,剖宫产率最低,宫缩过强、羊水粪染发生率最低;Ⅱ组剖宫产率最高;Ⅲ组宫缩过强、羊水粪染发生率明显高于其他三组。新生儿窒息仅Ⅲ组发生1例。结论宫颈扩张棒、普贝生和米索前列醇均有明显的促宫颈成熟作用。在宫颈扩张棒首先促宫颈成熟的基础上,配伍催产素用于低宫颈评分的足月妊娠引产,是一种安全、经济、有效的方法。
The aim is to provide a more appropriate method for term pregnancy induction of labor with low cervical score. Methods Totally 187 pregnant women with low cervix score (≤6 points) who had indications for induction of labor were randomly divided into groups. Among them, 71 cases were treated with cervical dilatation bar (group Ⅰ), 33 cases were treated with oxytocin (group Ⅱ), misoprostol 35 cases in group Ⅲ and 48 cases in group Pubei-sheng (Ⅳ group). The rate of cervical ripening, time from labor to delivery, planned delivery rate, mode of delivery and maternal and infant complications were compared . Results In group Ⅰ, 70 cases (99%) had cervical ripening, 5 cases (15%) in group Ⅱ, 32 cases (91%) in group Ⅲ, 45 cases (95%) in group Ⅳ, Compared with group Ⅱ, the difference was statistically significant (P <0.05). Group Ⅲ, Ⅳ induction of labor to labor time is shorter than Ⅰ, Ⅱ group; Ⅳ group the shortest time required, Ⅱ group the longest time. The four groups of total production time quite. The success rate of planned delivery was the highest in group Ⅰ (84%), and the success rate of scheduled delivery in other three groups was lower (15%, 23% and 27% in group Ⅱ, Ⅲ and Ⅳ respectively). Group Ⅰ had the highest rate of vaginal delivery, the lowest rate of cesarean section, too much contraction, the lowest incidence of meconium-stained amniotic fluid; the highest rate of cesarean section in group Ⅱ; the higher rate of uterine contractions in group Ⅲ and the higher incidence of meconium-stained amniotic fluid Three groups. Neonatal asphyxia occurred in only one group Ⅲ. Conclusions Cervical dilatation sticks, pethidine and misoprostol all promote the cervical ripening. On the basis of the cervical dilatation of cervical dilatation of the first cervical maturity, compatibility of oxytocin for low cervix score of full-term pregnancy induction is a safe, economical and effective method.