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目的:探讨提高米索前列醇用于晚期妊娠引产的安全性措施。方法:通过腹部检查、头盆评分、B超及胎心电子监护选择引产对象126例,随机分为两组,各63例。25微克组:米索前列醇25微克阴道用药,24小时重复一次,总量50微克。50微克组:米索前列醇50微克阴道用药,24小时重复一次,总量100微克。宫缩发动后由专人看护,并进行连续胎心、宫缩监护,直至分娩结束。用硫酸镁缓解宫缩过强。观察两组的引产成功率、促宫颈成熟效果、首次用药至临产时间、阴道分娩总产程以及分娩结局。结果:两组的引产成功率、首次用药至临产的时间及用药前后bishop评分的变化均无显著差异;25微克组阴道分娩的总产程显著长于50微克组,在Bishop评分≥5分的病例中,25微克组单次引产的成功率显著低于50微克组,二次给药后则无差异。两组均无母儿严重并发症。结论:为提高米索前列醇用于晚期妊娠引产的安全性,采用包括选择病例、合理用药及产程监护的综合措施是有益的。米索前列醇25微克阴道用药、24小时重复一次、总量50微克的用药方案作用温和,安全度高,值得推荐。
Objective: To explore the safety measures to increase misoprostol in late pregnancy induction of labor. Methods: 126 cases of induced abortion were selected by abdominal examination, head basin score, B ultrasound and fetal heart electronic monitoring, and were randomly divided into two groups of 63 cases. 25 micrograms group: misoprostol 25 micrograms vaginal medication, repeated 24 hours, a total of 50 micrograms. 50 micrograms group: misoprostol 50 micrograms vaginal medication, repeated 24 hours, a total of 100 micrograms. Uterine contractions mobilized by a person after care, and continuous fetal heart rate, contractions monitoring, until the end of childbirth. With magnesium sulfate to ease the contractions too strong. Observe the success rate of induction of labor in the two groups, promote cervical maturation effect, the first medication to the time of labor, vaginal delivery of labor and delivery outcomes. Results: There was no significant difference in the success rate of induction of labor, time from the first medication to labor and the change of bishop score before and after treatment. The incidence of vaginal delivery in 25 micrograms group was significantly longer than 50 microg while the Bishop score ≥5 , The success rate of single induced labor in 25 micrograms group was significantly lower than that of 50 micrograms and no difference after secondary administration. No serious complications were found in both groups. Conclusion: In order to improve the safety of misoprostol in induction of labor during late pregnancy, it is beneficial to adopt comprehensive measures including the selection of cases, rational drug use and labor control. Misoprostol 25 micrograms vaginal medication, repeated 24 hours, a total of 50 micrograms of the drug program mild, high safety, it is recommended.