A comparison of spontaneous labor with induced vaginal tablets prostaglandin E2 in grand multiparae.
A comparison of spontaneous labor with induced vaginal tablets prostaglandin E2 in grand multiparae.
复制标题
经产妇自然分娩与阴道诱导片前列腺素 E2 的比较。
作者：
A. Sobande;H. Al;E. Archibong
目的
目的比较经产妇（5帕拉以上）应用前列腺素E2阴道片引产与自然分娩的产程结局，观察引产过程中的并发症。
方法
1993年1月至1994年12月在Khamis Mushayt的费萨尔国王军事医院进行了一项回顾性病例对照研究。这包括64例使用前列腺素E2阴道片诱导的经产妇。90例自然分娩的巨产妇作为对照。从其医院记录文件中提取的母体和胎儿数据包括年龄、产次、引产适应症、引产时的Bishop评分、使用的前列腺素总剂量和引产并发症。其他信息包括产程长度、是否需要催产素、第三产程失血量、分娩方式、出生体重、性别和10分钟时的Apgar评分。
结果
在所研究的受试者中未观察到严重的引产并发症，如子宫破裂。两组患者的平均年龄和产次比较无显著性差异（P>0.05），但分娩时的孕周有显著性差异（P=0.00）。第一产程和第二产程的平均长度无显著差异。病例组和对照组的剖宫产率分别为11%和8%，而病例组对催产素隆乳的需求是对照组的两倍，分别为27%和14%。这些不具有统计学显著性。
结论
我们的结论是，与自然分娩的患者相比，前列腺素E2阴道片引产可能不会对分娩结局产生不良影响。前列腺素E2阴道片用于大产引产是安全的。我们建议进行随机前瞻性试验来验证这些观察结果。
OBJECTIVE
To compare the outcome of labor in grandmultiparous patients (para >5) who had induction of labor with prostaglandin E2 vaginal tablets with grandmultiparous patients in spontaneous labor, and to observe the complications during induction of labor.
METHODS
A retrospective case control study was carried out at King Faisal Military Hospital, Khamis Mushayt between January 1993 through until December 1994. This included 64 grandmultiparous patients that were induced with prostaglandin E2 vaginal tablets. Ninety grandmultiparous patients who went into labor spontaneously served as controls. Maternal and fetal data extracted from their hospital record files included age, parity, indication for induction, Bishop score at induction, total dose of prostaglandin used and complications of induction of labor. Other information were length of labor, need for syntocinon augmentation, blood loss during the 3rd stage of labor, mode of delivery, birth weight, sex and Apgar score at 10 minutes.
RESULTS
No serious complication of induction of labor such as rupture of the uterus was noted in the subjects studied. There were no significant differences when the mean age and parity of patients in the 2 groups were compared (P>0.05) but there was difference in the gestational age at delivery (p=0.00). There was no significant difference in the mean length of first and 2nd stages of labor. The cesarean section rate was 11% and 8% in the cases and controls, while the need for syntocinon augmentation was twice in the cases than controls, 27% vs 14%. These were not statistically significant.
CONCLUSION
We conclude that induction of labor with prostaglandin E2 vaginal tablets may not have adverse effect on the outcome of labor compared with patients in spontaneous labor. It may be safe to use prostaglandin E2 vaginal tablets for induction of labor in the grand- multiparae. We recommend a randomized prospective trial to validate these observations.