上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (8): 1212-.doi: 10.3969/j.issn.1674-8115.2011.08.037

• 短篇论著 • 上一篇    下一篇

卡前列甲酯栓预防瘢痕子宫中期妊娠引产产后出血的疗效观察

董 颖   

  1. 上海浦东新区公利医院妇产科, 上海 200135
  • 出版日期:2011-08-28 发布日期:2011-08-29
  • 作者简介:董 颖（1974—）, 女, 主治医师, 学士；电子信箱: xdygogo2009@sina.com。

Effects of Carboprost on prevention of hemorrhage after induced labor with scarred uterus

DONG Ying   

  1. Department of Obstetrics and Gynecology, Shanghai Pudong New Area GongLi Hospital, Shanghai 200135, China
  • Online:2011-08-28 Published:2011-08-29

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摘要：

目的 观察卡前列甲酯栓对瘢痕子宫中期妊娠引产妇女第三产程及产后出血量的影响。方法 将100例瘢痕子宫中期妊娠引产的妇女随机分成卡前列甲酯栓组和缩宫素组，每组各50例。所有妇女均口服米非司酮50 mg，每日2次,共2 d；第3天行依沙吖啶100 mg羊膜腔内注射。卡前列甲酯栓组妇女在胎儿娩出后即刻含服卡前列甲酯栓2 mg，缩宫素组妇女在胎儿娩出即刻宫体注射缩宫素20 IU。比较两组妇女第三产程时间、产后2 h及产后24 h出血量、胎盘残留率、血压及脉搏变化（产前及产后30 min、1 h、2 h、24h）、不良反应发生情况。结果 卡前列甲酯栓组产后2 h、24 h出血量及第三产程时间明显少于缩宫素组（P＜0.05），胎盘残留率（10%）低于缩宫素组（26%）(P<0.05)。两组各时间点血压、脉搏比较，差异无统计学意义(P>0.05)。卡前列甲酯栓组不良反应发生率（34%）明显高于缩宫素组（18%）（P＜0.05）。结论 卡前列甲酯栓用于瘢痕子宫中期妊娠引产，可减少产后出血量, 缩短第三产程时间，降低胎盘残留率。

关键词: 卡前列甲酯栓, 瘢痕子宫, 引产, 产后出血

Abstract:

Objective To observe the effects of carboprost on third stage of labor and postpartum hemorrhage in induced labor with scarred uterus. Methods One hundred women undergoing induced labor with scarred uterus were randomly divided into carboprost group and oxytocin group, with 50 women in each group. All women were orally administered 50 mg mifepristone twice a day for 2 d, and received injection of 100 mg acetamiprid in amniotic cavity on the third day. Women in carboprost group were orally administered 2 mg carboprost immediately after delivery, and those in oxytocin group received intrauterine injection of 20 IU oxytocin immediately after delivery. The duration of third stage of labor, volumes of postpartum hemorrhage (2 h and 24 h after delivery), rate of placenta residue, blood pressure (before delivery and 30 min, 1 h, 2 h and 24 h after delivery), pulse (before delivery and 30 min, 1 h, 2 h and 24 h after delivery) and occurrence of adverse effects were compared between two groups. Results The duration of third stage of labor and volumes of hemorrhage 2 h and 24 h after delivery in carboprost group were significantly lower than those in oxytocin group (P＜0.05), and the rate of placenta residue in carboprost group was significantly lower than that in oxytocin group (10% vs 26%, P＜0.05). There was no significant difference in the blood pressure and pulse at different time points between two groups (P>0.05). The prevalence of adverse effects in carboprost group was significantly higher than that in oxytocin group (34% vs 18%, P＜0.05). Conclusion Application of carboprost in induced labor with scarred uterus may reduce volume of postpartum hemorrhage, shorten duration of third stage of labor, and decrease rate of placenta residue.

Key words: Carboprost, scar uterus, induced labor, postpartum hemorrhage