【摘要】 目的:研究分析不同宫颈Bishop评分、不同引产方法的时效及对母儿的影响。方法:将413例孕足月单胎头位具有引产指征、按不同宫颈评分随机分成A、B、C三组,每组分别采用米索、催产素、蓖麻油引产餐三种方法引产。统计学分析不同宫颈评分、不同药物引产方法引产效果及母儿并发症影响。结果:A组和B组用米索引产可显著改善宫颈评分(P<0.01),提高引产成功率及阴道分娩率(P<0.005),而催产素引产效果最差。C组用米索和催产素引产效果无显著性差异(P>0.05),而引产餐引产效果低于其他两种方法(P<0.05)。催产素引产时剖宫产率显著高于其他两种方法犤A、B组(P<0.005),C组P<0.025犦。米索引产时,A组羊水污染率及新生儿窒息率显著高于催产素和引产餐(P值分别<0.005,<0.025)。结论:宫颈Bishop评分≤5分时不宜用催产素引产。低宫颈评分用米索引产效果佳,但需严密监护。蓖麻油引产餐引产效果次于米索。宫颈条件成熟时(宫颈评分≥6分)用米索和催产素引产效果佳,但用各种引产方法均需加强监护。更多还原

【Abstract】 Objective To compare the efficiency of different Bishop scores using three different methods of labor induction and their related maternal and infant complications.Methods 413 pregnant women with term singleton vertex fetus pregnancies were randomly distributed into three groups ( Group A, Group B and Group C ) in which they showed the Bishop score of less than or equal to 4,5,or equal to or more than 6(6or7) respectively. Three methods were used in each group:50ug misoprostol was placed in the posterior vaginal fornix every 4 hours, Oxytocin at 5% was intravenously dripped or castor oil- diet was offered. Results In Group A and Group B, misoprostol improved the conditions aroused by low Bishop scores obviously(P<0.01), raised the success rate of labor induction and that of parturition through vagina( P<0.005) . In Group C no significant difference was found between misoprostol pattern and Oxytocin pattern( P>0.05) . The effect of castor oil- diet was less than that of misoprostol and Oxytocin( P<0.05) . The incidence of meconium in Oxytocin pattern was much more than in misoprostol pattern and castor oil- diet pattern(In Group A or B P<0.005,In Group C P<0.025). In Group A, the incidence of stained amniotic fluid and neonatal asphyxia in misoprostol pattern was much more than that in Oxytocin pattern( P<0.005) and in castor oil- diet pattern( P<0.025) .Conclusion Oxytocin will not be recommended to use when the Bishop score was less than or equal to 5. Misoprostol is an efficient agent for labor induction at low Bishop scores and it may ripen the cervix better than Castor oil- diet but the use of that and other agents at high Bishop scores all require care monitoring.更多还原