欣普贝生对宫颈未成熟足月妊娠产妇分娩方式和妊娠结局的影响
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摘要
目的探讨欣普贝生对宫颈未成熟足月妊娠产妇分娩方式和妊娠结局的影响。方法选择2017年1月至2018年10月期间在商洛市中医医院妇产科住院的92例宫颈未成熟足月妊娠产妇为研究对象,根据随机数表法将其分为观察组与对照组,每组46例。对照组使用缩宫素促宫颈成熟,观察组则应用欣普贝生。比较两组产妇用药前后宫颈Bishop评分,评估促宫颈成熟效果,同时记录产妇分娩方式及新生儿窒息、高胆红素血症发生率以及新生儿Apgar评分。结果用药后6 h、12 h,观察组产妇宫颈Bishop评分分别为(5.69±1.34)分、(7.62±1.51)分,均明显高于对照组的(4.10±0.86)分、(5.58±1.12)分,差异均有统计学意义(P<0.05);观察组产妇的促宫颈成熟总有效率为93.48%,明显高于对照组的73.91%,产妇剖宫产率为26.09%,明显低于对照组的45.65%,新生儿高胆红素血症发生率为2.17%,也明显低于对照组的13.04%,差异均有统计学意义(P<0.05);观察组新生儿窒息发生率、新生儿Apgar评分分别为2.17%、(9.35±1.25)分,与对照组的4.35%、(9.24±1.08)分比较差异均无统计学意义(P>0.05)。结论欣普贝生应用于宫颈未成熟足月妊娠产妇,可以有效促进宫颈成熟,降低剖宫产率,从而改善母婴结局,且具有较高的安全性。
Objective To investigate the effect of Propess(Dinoprostone Suppositories) on the delivery mode and pregnancy outcome of full-term pregnant women with immature cervix. Methods A total of 92 cases of cervical immature full-term pregnant women were selected as subjects, who were hospitalized in the Department of Obstetrics and Gynecology at Shangluo Traditional Chinese Medicine Hospital from January 2017 to October 2018. According to the random number table method, they were divided into observation group and control group, with 46 cases in each group. The control group was treated with Oxytocin to promote cervical ripening, while the observation group was treated with Propess. The Bishop scores of the cervix before and after maternal administration were compared between the two groups, and the cervical ripening effect was evaluated. The mode of delivery, the incidence of neonatal asphyxia and hyperbilirubinemia, and the Apgar score of neonates were recorded at the same time. Results At 6 h and 12 h after medication, the Bishop score of maternal cervixes was respectively 5.69±1.34 and 7.62±1.51 in the observation group, which were significantly higher than corresponding 4.10±0.86 and 5.58±1.12 in the control group(P<0.05). In the observation group, the total effective rate of cervical ripening was 93.48%, which was significantly higher than 73.91% in the control group; the maternal cesarean section rate was 26.09%, which was significantly lower than 45.65% in the control group;the incidence of neonatal hyperbilirubinemia was 2.17%, which was also significantly lower than 13.04% in the control group; all differences were statistically significant(P<0.05). The incidence of neonatal asphyxia and Apgar score were respectively 2.17% and 9.35±1.25 in the observation group, compared with corresponding 4.35% and 9.24±1.08 in the control group, with no statistically significant differences(P>0.05). Conclusion The application of Propess(Dinoprostone Suppositories) in full-term pregnant women with immature cervix can effectively promote cervical ripening, reduce the rate of cesarean section, thereby improving maternal and infant outcomes, and has high safety.
Objective To investigate the effect of Propess(Dinoprostone Suppositories) on the delivery mode and pregnancy outcome of full-term pregnant women with immature cervix. Methods A total of 92 cases of cervical immature full-term pregnant women were selected as subjects, who were hospitalized in the Department of Obstetrics and Gynecology at Shangluo Traditional Chinese Medicine Hospital from January 2017 to October 2018. According to the random number table method, they were divided into observation group and control group, with 46 cases in each group. The control group was treated with Oxytocin to promote cervical ripening, while the observation group was treated with Propess. The Bishop scores of the cervix before and after maternal administration were compared between the two groups, and the cervical ripening effect was evaluated. The mode of delivery, the incidence of neonatal asphyxia and hyperbilirubinemia, and the Apgar score of neonates were recorded at the same time. Results At 6 h and 12 h after medication, the Bishop score of maternal cervixes was respectively 5.69±1.34 and 7.62±1.51 in the observation group, which were significantly higher than corresponding 4.10±0.86 and 5.58±1.12 in the control group(P<0.05). In the observation group, the total effective rate of cervical ripening was 93.48%, which was significantly higher than 73.91% in the control group; the maternal cesarean section rate was 26.09%, which was significantly lower than 45.65% in the control group;the incidence of neonatal hyperbilirubinemia was 2.17%, which was also significantly lower than 13.04% in the control group; all differences were statistically significant(P<0.05). The incidence of neonatal asphyxia and Apgar score were respectively 2.17% and 9.35±1.25 in the observation group, compared with corresponding 4.35% and 9.24±1.08 in the control group, with no statistically significant differences(P>0.05). Conclusion The application of Propess(Dinoprostone Suppositories) in full-term pregnant women with immature cervix can effectively promote cervical ripening, reduce the rate of cesarean section, thereby improving maternal and infant outcomes, and has high safety.
引文
[1]戴夏琳.足月妊娠促宫颈成熟及引产的应用进展[J].中国妇幼保健, 2016, 31(24):5534-5536.
[2]任虹,张霖,范剑虹,等. COOK双球囊导管在足月妊娠引产中的临床研究[J].现代生物医学进展, 2016, 16(17):3282-3285.
[3]刘丽园,唐玲,李海英,等.缩宫素在瘢痕子宫妊娠催产中的应用[J].海南医学, 2017, 28(8):1345-1346.
[4]林莉,孙波,王欣昱,等.欣普贝生用于足月妊娠促宫颈成熟及引产效果的临床分析[J].海峡药学, 2015, 27(6):166-169.
[5]沈琪,郑韧.地诺前列酮栓与米索前列醇用于过期妊娠促宫颈成熟及引产的效果观察[J].中国乡村医药, 2014, 21(5):17-18.
[6]何秋.足月妊娠引产应用不同方法对促宫颈成熟的预后效果分析[J].中国计划生育和妇产科, 2016, 8(4):62-64, 66.
[7]唐婷.足月妊娠胎膜早破孕妇不同时间引产的效果观察[J].中国现代医生, 2016, 54(25):51-53, 57.
[8]周冬,赵云,肖梅.晚期足月妊娠不同方式引产的临床观察[J].中国妇幼保健, 2018, 33(11):2422-2426.
[9]樊晓然.促宫颈成熟药物对延期妊娠孕妇分娩结局及围产儿的影响[J].海南医学, 2014, 25(9):1289-1291.
[10]王国华,刘亚琼,石丹.低位水囊与米索前列醇对足月妊娠促宫颈成熟引产效果观察[J].中国现代医生, 2015, 53(36):44-46.
[11]冯敏锋,吴丽琼,王海霞. COOK双球囊联合缩宫素在宫颈不成熟足月引产中的应用[J].海南医学, 2017, 28(9):1513-1515.
[12]陈乔珠,王海涛.宫颈分泌物fFN检测联合Bishop评分对缩宫素引产结局的预测[J].中国妇产科临床杂志, 2015, 16(3):244-245.
[13]史晓红.缩宫素联合卡前列素氨丁三醇预防剖宫产术后出血的疗效及对血流动力学的影响[J].中国实用医刊, 2017, 44(3):87-90.
[14]李丽,袁秀红,罗晓梅,等.缩宫素联合前列腺素类药物预防高危妊娠且行剖宫产产后出血的临床观察[J].现代药物与临床, 2014, 29(6):619-622.
[15]沈恩光,马玉华,阮菊意.不同剂量缩宫素对剖宫产术中产妇血流动力学的影响[J].中国药业, 2013, 22(11):21-22.
[16] HOU L, ZHU Y, MA XM, et al. Clinical parameters for prediction of successful labor induction after application of intravaginal dinoprostone in nulliparous Chinese women[J]. Med Sci Monit, 2012, 18(8):518-522.
[17]李珊珊,王欣.足月妊娠促宫颈成熟及引产药物应用进展[J].山东医药, 2015, 55(43):95-97
[18]陈金枝.欣普贝生用于足月妊娠引产的临床效果观察[J].海峡药学, 2016, 28(9):112-114.
[19]张新影.欣普贝生应用于延期和过期妊娠促宫颈成熟及引产中的效果观察及安全性分析[J].黑龙江医药, 2017, 30(2):342-344.
[2]任虹,张霖,范剑虹,等. COOK双球囊导管在足月妊娠引产中的临床研究[J].现代生物医学进展, 2016, 16(17):3282-3285.
[3]刘丽园,唐玲,李海英,等.缩宫素在瘢痕子宫妊娠催产中的应用[J].海南医学, 2017, 28(8):1345-1346.
[4]林莉,孙波,王欣昱,等.欣普贝生用于足月妊娠促宫颈成熟及引产效果的临床分析[J].海峡药学, 2015, 27(6):166-169.
[5]沈琪,郑韧.地诺前列酮栓与米索前列醇用于过期妊娠促宫颈成熟及引产的效果观察[J].中国乡村医药, 2014, 21(5):17-18.
[6]何秋.足月妊娠引产应用不同方法对促宫颈成熟的预后效果分析[J].中国计划生育和妇产科, 2016, 8(4):62-64, 66.
[7]唐婷.足月妊娠胎膜早破孕妇不同时间引产的效果观察[J].中国现代医生, 2016, 54(25):51-53, 57.
[8]周冬,赵云,肖梅.晚期足月妊娠不同方式引产的临床观察[J].中国妇幼保健, 2018, 33(11):2422-2426.
[9]樊晓然.促宫颈成熟药物对延期妊娠孕妇分娩结局及围产儿的影响[J].海南医学, 2014, 25(9):1289-1291.
[10]王国华,刘亚琼,石丹.低位水囊与米索前列醇对足月妊娠促宫颈成熟引产效果观察[J].中国现代医生, 2015, 53(36):44-46.
[11]冯敏锋,吴丽琼,王海霞. COOK双球囊联合缩宫素在宫颈不成熟足月引产中的应用[J].海南医学, 2017, 28(9):1513-1515.
[12]陈乔珠,王海涛.宫颈分泌物fFN检测联合Bishop评分对缩宫素引产结局的预测[J].中国妇产科临床杂志, 2015, 16(3):244-245.
[13]史晓红.缩宫素联合卡前列素氨丁三醇预防剖宫产术后出血的疗效及对血流动力学的影响[J].中国实用医刊, 2017, 44(3):87-90.
[14]李丽,袁秀红,罗晓梅,等.缩宫素联合前列腺素类药物预防高危妊娠且行剖宫产产后出血的临床观察[J].现代药物与临床, 2014, 29(6):619-622.
[15]沈恩光,马玉华,阮菊意.不同剂量缩宫素对剖宫产术中产妇血流动力学的影响[J].中国药业, 2013, 22(11):21-22.
[16] HOU L, ZHU Y, MA XM, et al. Clinical parameters for prediction of successful labor induction after application of intravaginal dinoprostone in nulliparous Chinese women[J]. Med Sci Monit, 2012, 18(8):518-522.
[17]李珊珊,王欣.足月妊娠促宫颈成熟及引产药物应用进展[J].山东医药, 2015, 55(43):95-97
[18]陈金枝.欣普贝生用于足月妊娠引产的临床效果观察[J].海峡药学, 2016, 28(9):112-114.
[19]张新影.欣普贝生应用于延期和过期妊娠促宫颈成熟及引产中的效果观察及安全性分析[J].黑龙江医药, 2017, 30(2):342-344.