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目的：评价米索前列醇用于晚期妊娠促宫颈成熟的有效性及安全性。方法：采用随机双盲临床对照试验。宫颈Ｂｉｓｈｏｐ评分＜７分、有引产指征的单胎、头位妊娠８５例，分为试验组４３例（阴道给米索前列醇１００μｇ），对照组４２例（给予安慰剂）。用药前及用药１２小时后进行宫颈Ｂｉｓｈｏｐ评分，胎心电子监护，脐动脉、胎儿大脑中动脉和肾动脉收缩期最大血流速度（Ｓ）与舒张末期血流速度（Ｄ）的比值（Ｓ／Ｄ值）测定。如１２小时不临产，按常规行催产素引产。产后留取胎盘及蜕膜组织进行组织学观察。结果：用药１２小时后，试验组宫颈Ｂｉｓｈｏｐ评分升高平均为４．４±２．２分，明显高于对照组的１．０±０．９分。试验组用药后１２小时内自然临产发生率为６７．４％（２９／４３），显著高于对照组的１４．３％（６／４２）。两组用药前后脐动脉、大脑中动脉及肾动脉Ｓ／Ｄ值差异均无显著性（Ｐ＞０．０５）。两组胎心率监护异常发生率、胎儿窘迫发生率及新生儿Ａｐｇａｒ评分差异均无显著性。组织学观察除绒毛干及绒毛内血管呈不同程度扩张外，试验组胎盘及蜕膜组织学改变与对照组无其它不同。结论：米索前列醇（１００μｇ）用于晚期妊娠促宫颈成熟，安全、有效、用药方便。
Objective: To evaluate the efficacy and safety of misoprostol in promoting cervical ripening in late pregnancy. Methods: Randomized double-blind clinical control trial. Cervical Bishop score <7 points, a single child with induction of labor indications, the first position of 85 cases of pregnancy, divided into the experimental group of 43 cases (vaginal misoprostol 100μg), the control group of 42 patients (given placebo). The Bishop score, fetal electronic monitoring, ratio of peak systolic blood flow (S) to diastolic blood flow (D) in umbilical artery, fetal middle cerebral artery and renal artery before and 12 hours after medication were recorded. The ratio of S / D value). If not 12-hour labor, according to conventional oxytocin induction. Postpartum fetus and decidual tissue from the histological observation. Results: After 12 hours of treatment, the cervical Bishop score of the experimental group increased by an average of 4.4 ± 2.2 points, which was significantly higher than that of the control group by 1.0 ± 0.9 points. The incidence of spontaneous labor within 12 hours after treatment in the test group was 67.4% (29/43), significantly higher than that in the control group (14.3%, 6/42). Before and after treatment, the S / D values of umbilical artery, middle cerebral artery and renal artery had no significant difference (P> 0.05). There was no significant difference between the two groups in the incidence of anomalous fetal heart rate monitoring, the incidence of fetal distress and neonatal Apgar scores. Histological observation In addition to villus and villus in villus were varying degrees of expansion, the experimental group of placenta and decidual histological changes and the control group no other difference. Conclusion: Misoprostol (100μg) is used to promote cervical ripening in late pregnancy, which is safe, effective and convenient for medication.