Application of low-dose misoprostol in labor induction in patients with severe preeclampsia
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摘要: 目的 探讨小剂量米索前列醇用于重度子痫前期引产的有效性与安全性。 方法 回顾性分析重度子痫前期,宫颈不成熟(Bishop评分 ≤ 5分)引产的60例初产妇,其中米索前列醇组及欣普贝生组各30例,比较2组的阴道分娩率及母婴不良反应发生率。 结果 小剂量米索前列醇组及欣普贝生组阴道分娩率分别为76.67%和73.33%,2组比较差异无统计学意义(P>0.05);2组促宫颈成熟效果相当,宫颈评分均增加[2.84±0.74 vs. 2.68±0.88,P>0.05];当宫颈Bishop评分<4分时,米索组引产至临产时间较欣普贝生组长[(11.13±2.02) h vs. (9.43±1.72) h,P<0.01],当宫颈Bishop评分 ≥ 4分时2组时限相当[(6.67±2.53) h vs.(6.34±2.12) h,P>0.05];总产程2组差别无统计学意义[(6.33±1.04) h vs. (6.20±1.22) h,P>0.05]。临产时欣普贝生组血压高于米索组,差异具有统计学意义(P<0.01);2组新生儿窒息率、产后出血量及其他不良反应发生率差异无统计学意义(P>0.05)。 结论 在重度子痫前期引产中,小剂量米索前列醇安全有效,能提高阴道分娩率,引产过程中血压相对平稳,产妇耐受性较好,值得在临床上应用。Abstract: Objective To investigate the efficacy and safety of low-dose misoprostol in the labor induction in patients with severe preeclampsia. Methods A total of 60 severe preeclampsia women with an unfavourable cervices (Bishop Score ≤ 5 scores) were collected for retrospective analysis.They were randomized for labor induction with either low-dose misoprostol (30 cases) or dinoprostone (30 cases).The rate of vaginal delivery and the maternal-neonatal adverse reactions between the two groups were compared. Results The vaginal delivery rate in low-dose misoprostol group and dinoprostone group were 76.67% and 73.33%,respectively,there was no statistically difference (P>0.05).They were both effective in promoting cervical ripening,the increase in Bishop score was 2.84±0.74 vs.2.68±0.88,P>0.05.The induction-to-labor interval was longer in the misoprostol group[(11.13±2.02) h]than that in the dinoprostone group[(9.43±1.72) h]when the Bishop score<4,P<0.01,and there were no difference between the two groups[(6.67±2.53) h vs.(6.34±2.12) h]when the Bishop score ≥ 4,P>0.05.The difference of total stages of labor were not significant[(6.33±1.04) h vs.(6.20±1.22) h],P>0.05.Compared with the misoprostol group,the blood pressure were higher in the dinoprostone group when being in labor.There was no difference in the rate of asphyxia,postpartum hemorrhage and other adverse reactions between the two groups (P>0.05). Conclusion Low-dose misoprostol is safe and effective in the labor induction in patients with severe preeclampsia.The blood pressure can maintain relatively stable during the induction of labor,and the maternal tolerance is better.It can improve the rate of vaginal delivery,and is worthy of clinical application.
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Key words:
- Misoprostol /
- Severe preeclampsia /
- Induced labor /
- Dinoprostone suppository
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