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目的观察地诺前列酮栓在足月妊娠引产中的应用与促进宫颈成熟的效果的护理体会。方法选取2015年3~6月医院住院分娩的77例足月妊娠孕妇为研究对象,所有孕妇均无引产禁忌证,有阴道试产适应证,比较宫颈放药前后Bishop评分,观察宫缩、临产时间、分娩情况、阴道分娩率、产后出血以及对新生儿的影响,分析孕妇用药后6、12、18、24 h宫颈成熟与引产效果。结果放药后6 h宫颈评分开始改善,随着放药时间延长宫颈评分提高明显,至12 h平均提高达2.15分。用药后6、12、18 h及24 h的宫颈评分均高于用药前(P<0.05)。随着放药时间的推移,地诺前列酮栓对宫颈促成熟的效果更加明显,显效率66.2%(51/77),促宫颈成熟总有效率93.5%(72/77)。引产临产成功率74.03%(57/77),其中经阴道分娩53例,剖宫产24例,含有孕妇拒绝继续阴道试产2例,活跃期停滞2例,胎心出现晚期减速3例,羊水粪染2例,其余15例宫颈评分都有不同程度成熟,拒绝改用催产素引产,要求结束分娩,因此在促宫颈成熟方面是有效的。新生儿体质量在(3.25±0.635)kg,1例新生儿Argar评分1 min 7分、5 min9分、10 min 10分,其余新生儿Apgar评分1 min 9分、5 min 10分、10 min 10分,羊水粪染2例,其余羊水清。发生产后出血1例。结论地诺前列酮栓用于足月妊娠引产中促宫颈成熟效果显著,可在足月妊娠引产中推广使用。
Objective To observe the application of dinoprostone suppository in induced abortion of term pregnancy and the nursing experience of promoting cervical ripening. Methods A total of 77 full-term pregnant women who were admitted to hospital from March to June in 2015 were enrolled in this study. All pregnant women had no contraindications for contraception, and had vaginal trial-produced indications. Bishop scores before and after cervical discharge were compared. Contractions, Time, delivery, vaginal delivery rate, postpartum hemorrhage and neonatal impact, analysis of pregnant women 6,12,18,24 h after cervical ripening and induction of labor. Results The cervical score began to improve at 6 hours after drug release. With the prolongation of drug release, the cervical score increased significantly, reaching an average of 2.15 points after 12 hours. Cervical scores at 6, 12, 18 h and 24 h after treatment were higher than those before treatment (P <0.05). With the passage of time, dinoprostone suppository to cervical maturation effect more obvious, markedly effective rate 66.2% (51/77), the total effective rate of cervical ripening 93.5% (72/77). The success rate of induction of labor was 74.03% (57/77), including 53 cases of vaginal delivery, 24 cases of cesarean section, pregnant women refused to continue the vaginal delivery in 2 cases, 2 cases of active arrest, late fetal heart rate deceleration in 3 cases, amniotic fluid Fecal staining in 2 cases, the remaining 15 cases of cervical score have varying degrees of maturity, refused to switch to oxytocin induction of labor, requiring the end of childbirth, and therefore in promoting cervical maturity is effective. Neonatal body weight was (3.25 ± 0.635) kg, 1 neonatal Argar score 1 min 7 min, 5 min 9 min, 10 min 10 min, and other neonatal Apgar score 1 min 9 min, 5 min 10 min, 10 min 10 Min, amniotic fluid fecal dye in 2 cases, the rest amniotic fluid clear. Postpartum hemorrhage occurred in 1 case. Conclusion The use of dinoprost suppository is effective in inducing cervical maturation in full-term pregnancy and it can be used in induction of full-term pregnancy.