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目的探讨地诺前列酮用于妊娠足月羊水过少产妇引产的有效性和安全性。方法选择2009年3月-2014年3月140例足月妊娠羊水过少产妇,按引产方式不同分为地诺前列酮组(n=76)和缩宫素组(n=64),比较两组的宫颈评分改变、临产和分娩情况、新生儿情况以及不良反应。结果地诺前列酮组与缩宫素组促宫颈成熟有效率分别为92.1%、62.4%,进入产程时间分别为(9.2±5.7)、(30.8±9.1)h,产程分别为(5.2±2.6)、(10.8±3.9)h,阴道分娩率分别为87.0%、56.1%,剖宫产率分别为13.0%、43.9%,住院时间分别为(3.5±1.3)、(6.3±1.5)d,以上指标组间差异均有统计学意义(P<0.001);两组产后2 h出血量分别是(216±129)、(223±148)m L,新生儿窒息发生率分别是3.9%、3.1%,差异无统计学意义(P>0.05)。结论羊水过少并非阴道分娩禁忌证,地诺前列酮用于足月妊娠羊水过少产妇引产较为安全有效,能显著提高阴道分娩率,降低剖宫产率。
Objective To investigate the efficacy and safety of dinoprostone in induction of labor in oligohydramnios of pregnant women with term pregnancy. METHODS: From March 2009 to March 2014, 140 cases of term mothers with oligohydramnios were divided into dinoprostone group (n = 76) and oxytocin group (n = 64) Group cervical score changes, labor and childbirth, newborns and adverse reactions. Results The effective rate of cervix ripening in the dinoprostone group and the oxytocin group was 92.1% and 62.4% respectively. The time of entering labor was (9.2 ± 5.7) and (30.8 ± 9.1) , (10.8 ± 3.9) h, vaginal delivery rates were 87.0%, 56.1%, cesarean section rates were 13.0%, 43.9%, hospital stay were (3.5 ± 1.3), (6.3 ± 1.5) d, The difference of blood pressure between the two groups was (216 ± 129) and (223 ± 148) m L respectively at 2 h postpartum, and the incidences of neonatal asphyxia were 3.9% and 3.1% respectively (P <0.001) The difference was not statistically significant (P> 0.05). Conclusions: Oligohydramnios is not contraindicated in vaginal delivery. Dinoprostone is safe and effective in labor induction of term oligohydramnios in term pregnancy. It can significantly improve vaginal delivery rate and reduce cesarean section rate.