[催产素在自然分娩和引产中初产和多产妇女的子宫活动]。

J L Trujillo, N L Gonzalez, J Parache
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引用次数: 0

摘要

对40例自然分娩(20例初产妇和20例多产)和40例催产素引产(20例初产和20例多产)的5187例羊膜内分娩压力曲线进行了分析。子宫扩张分为三个阶段——阶段1,宫颈扩张至2cm;第二阶段,宫颈扩张2至4厘米,第三阶段,宫颈扩张4厘米直至完全。在活跃期,从2厘米到子宫完全扩张,在宫缩的频率和幅度方面,引产和自然分娩之间没有观察到差异。引产的子宫活动度、最大收缩速度、扩张速度等指标均高于自然产程,总产程等指标均低于自然产程。宫缩/扩张速度是监测药物刺激产程效果的重要参数。在自然分娩的潜伏期,多宫缩比初产多。这一事实应该有足够的理由在这一阶段加强对母亲和胎儿的监测。根据这些结果,在没有分娩进展的情况下,似乎明智的做法是明确区分宫颈成熟和促进子宫活动的目标,并相应地制定不同的药物治疗。
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[Uterine activity in primiparous and multiparous women in spontaneous labor and induced labor with oxytocin].

An analysis was performed of 5187 intra-amniotically measured labor pressure curves in 40 births with spontaneous labour (20 primiparae and 20 multiparae) and 40 births births in which labor was induced with oxytocin (20 primiparae and 20 multiparae). The dilatation of the os uteri was divided into three phases--Phase 1, dilatation of the cervix to 2 cm; Phase 2, dilatation of the cervix from 2 to 4 cm, and Phase 3, dilatation from 4 cm onwards until complete. During the active phase, from 2 cm until dilatation of the os uteri was complete, no differences were observed between induced and spontaneous labor with regard to frequency and amplitude of contractions. In the induced-labor cases, the parameters for uterine activity, maximum contraction and dilatation speed were higher in all three phases of labor, and those for total duration of labor lower than in the spontaneous labor cases. The contraction/dilatation speed is an important parameter for monitoring the effect of drug-induced stimulation of labor. In the latency phase in spontaneous labor, more contractions were observed in multiparae than in primiparae. This fact which should be reason enough to intensify monitoring of both mother and fetus during this phase. In light of these results it would appear advisable, in the absence of progress in labor, to make a clear distinction between the goals of cervical maturity and promotion of uterine activity, and to institute different drug therapy accordingly.

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[Symposium on Uterine Contraction and Beginning of Labor. Aachen, September 1993]. [Uterine contraction and labor onset. Overview]. [Control of labor onset in the human]. [Biochemical principles of cervix ripening and dilatation]. [Role of the cervix uteri at labor onset from ultrasound studies].
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