Labor Induction With Continuous Low-Dose Oxytocin Infusion: A Randomized Trial
Labor Induction With Continuous Low-Dose Oxytocin Infusion: A Randomized Trial
复制标题
持续低剂量催产素输注引产：一项随机试验
作者：
B. Mercer;Paula Pilgrim;B. Sibai
123名妇女随机接受两种催产素诱导方案中的任何一种。61人接受低剂量治疗，每隔不少于60分钟增加一次催产素。未成熟宫颈患者在膜破裂前接受长时间低剂量催产素刺激。另外62人接受了传统的治疗方案，每20分钟根据需要增加催产素。当认为安全可行时，两组均行羊膜切开术。在低剂量和传统方案受试者中，分别有29%和58%的人对子宫过度刺激或胎儿心率异常模式进行了调整（P< 0.001，优势比3.6）。低剂量催产素输注未见分娩时间明显增加。剖宫产和因胎儿窘迫而剖宫产在传统方案组更为常见。本研究表明，连续低剂量催产素诱导分娩是有效的建立主动分娩和实现阴道分娩的妇女成熟和不成熟的服务。与该机构的传统方案相比，它还与需要调整催产素输注的子宫过度刺激发作次数减少有关。
One hundred twenty-three women were randomized to receive either of two regimens of oxytocin for labor induction. Sixty-one received a low-dose regimen, with oxytocin increases at intervals of not less than 60 minutes. Patients with unripe cervices received prolonged low-dose oxytocin priming before membrane rupture. Sixty-two others received a traditional protocol, with oxytocin increased every 20 minutes as required. Both groups had amniotomy when deemed safe and feasible. Oxytocin was adjusted for uterine hyperstimulation or abnormal fetal heart rate patterns in 29 and 58% of low-dose and traditional protocol subjects, respectively (P<.001, odds ratio 3.6). No significant increase in time to delivery was seen with low-dose oxytocin infusion. Cesarean delivery and cesareans for fetal distress were more frequent in the traditional protocol group. This study demonstrates that a continuous low-dose protocol for oxytocin induction of labor is effective in establishing active labor and achieving vaginal delivery in women with both ripe and unripe cervices. It is also associated with fewer episodes of uterine hyperstimulation requiring adjustments of oxytocin infusion than is the traditional protocol of this institution.