一项随机对照研究:持续输注催产素至分娩与在产程活跃期停止输注催产素的剖宫产率

Lalida Chookijkul, S. Prommas, Piyawan Pariyawateekul, Nawaporn Orungrote, Buppa Smanchat, K. Suwannarurk
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引用次数: 3

摘要

目的:比较产程活跃期确定后停止催产素输注引产或助产与继续输注催产素直至分娩的剖宫产率。材料和方法:这是一项前瞻性随机对照试验,纳入了2014年2月至2015年1月在普密蓬阿杜德医院接受引产或隆胸术的340名孕妇。将产妇随机平均分为两组。继续组在分娩的所有阶段均接受催产素输注。停药组接受催产素输注,在产程活跃期开始时提前停药。本研究采用意向治疗分析。结果:340名孕妇参加了这项研究。他们被随机分为两组,每组170名患者。继续组和停止组剖宫产率分别为31.8%和27.7% (p = 0.40)。CG组有15例患者因胎心不稳定而停止静脉输液,使用的催产素总剂量显著高于DG组。DG组因子宫收缩不良,需追加催产素。各产程持续时间、产妇并发症及新生儿不良结局无显著差异。停药组仅有2例产后出血经药物治疗成功。结论:产程活跃期停用或继续使用催产素是否影响剖宫产率尚无充分证据支持。然而,在继续组中使用了更高剂量的催产素。未来需要有足够样本量的良好随机设计。
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Cesarean Section Rate in Oxytocin Infusion between Continuous Until Delivery and Discontinuation at Active Phase of Labor: a Randomized Controlled Study
Objective: To compare the cesarean section rate between discontinuing oxytocin infusion for labor induction or augmentation when the active phase of labor is established and continuing oxytocin infusion until delivery. Materials and methods: This was a prospective randomized controlled trial of 340 pregnant women who underwent labor induction or augmentation at Bhumibol Adulyadej Hospital during February 2014 to January 2015. Parturient were randomly and equally allocated into two groups. The continued group received oxytocin infusion throughout all stages of labor. The discontinued group received oxytocin infusion and early discontinued when the active phase of labor had begun. Intention to treat analysis was used in this study. Results: Three hundred and forty pregnant women were enrolled for the study. They were assigned randomly into two groups, 170 patients for each group. Cesarean section rate in continued and discontinued group were 31.8% and 27.7%, respectively ( p = 0.40). The infusion of intravenous fluid in CG group was stopped due to non-reassuring fetal heart rate pattern in 15 women and total oxytocin doses used were significantly higher than that in DG group. In DG group, additional oxytocin was required due to poor uterine contraction. Duration of each stage of labor, maternal complications and adverse neonatal outcomes were not significantly different. There were only two cases of postpartum hemorrhage in discontinued group that was successful managed by medical treatment. Conclusion: There was not sufficient evidence to support whether discontinuation or continuation of oxytocin in active phase of labor influenced cesarean section rate. However, higher doses of oxytocin used was found in continuation group. Future well-randomized design with enough sample size is needed.
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来源期刊
Thai Journal of Obstetrics and Gynaecology
Thai Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
3
审稿时长
24 weeks
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