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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。
Objective To investigate the efficacy and safety of low dose misoprostol for induction of labor in severe preeclampsia. Methods Sixty primiparae of immature (Bishop score≤5) induced labor in severe preeclampsia and 30 cases of misoprostol and 30 cases in each group were analyzed retrospectively. The vaginal delivery rate, Maternal and child adverse reaction rate. Results The vaginal delivery rates of low-dose misoprostol group and Yanpengsheng group were 76.67% and 73.33%, respectively. There was no significant difference between the two groups (P> 0.05). The cervical ripening effect was similar in both groups, (2.84 ± 0.74 vs.2.68 ± 0.88, P> 0.05). When the cervical Bishop score was less than 4, the lead time of misoprostol to labor was longer than that of the newly-born group [(11.13 ± 2.02) h vs. (9.43 ± 1.72) h, P <0.01]. When the cervical Bishop score≥4, the duration of the two groups was comparable [(6.67 ± 2.53) h vs. (6.34 ± 2.12) h, P> 0.05) Significance [(6.33 ± 1.04) h vs. (6.20 ± 1.22) h, P> 0.05]. There was no significant difference in the incidence of asphyxia, postpartum hemorrhage and other adverse reactions between the two groups (P> 0.05), and the difference was statistically significant (P <0.01) ). Conclusions In the induction of labor with severe preeclampsia, low-dose misoprostol is safe and effective, which can improve vaginal delivery rate. The blood pressure during labor is relatively stable and the maternal tolerance is good. It is worth to be used clinically.