不同剂量缩宫素对剖宫产术后再次妊娠经阴道试产孕妇母婴结局的影响
The effect of different doses of oxytocin on maternal and infant outcomes in pregnant women undergoing trial of labour vaginally for a second pregnancy after caesarean section
李琴娣 1陈红霞 2徐展翅2
作者信息
- 1. 衢州市妇幼保健院 物资采购管理部,浙江 衢州 324100
- 2. 衢州市妇幼保健院 药剂科,浙江 衢州 324100
- 折叠
摘要
目的 探究不同剂量缩宫素(oxytocin,OT)对剖宫产术后再次妊娠经阴道试产(trial of labor after cesareansec-tion,TOLAC)孕妇产程进展、凝血功能和母婴结局的影响.方法 回顾性分析 138 例TOLAC孕妇临床病历资料,根据产程中OT总用量分为低剂量组 61 例、中剂量组 45 例和高剂量组 32 例,比较三组的产程进展、凝血功能、分娩方式、妊娠结局及围产儿结局.结果 三组第一产程、第二产程、第三产程及总产程比较,差异均无统计学意义(P>0.05);与用药前比,三组用药后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均降低,纤维蛋白原(FIB)水平均升高,差异有统计学意义(P<0.05),三组间用药后PT、APTT、FIB比较差异无统计学意义(P>0.05).低剂量组及中剂量组孕产妇的胎盘早剥、新生儿高胆红素血症发生率均低于高剂量组,差异有统计学意义(P<0.05).结论 OT可增强TOLAC孕妇子宫收缩力,改善凝血功能,但大剂量OT可能增加胎盘早剥及新生儿高胆红素血症发生风险.
Abstract
Objective The aim of this study was to investigate the impact of varying doses of oxytocin(OT)on the progression of labour,coagulation,and maternal and infant outcomes in pregnant women undergoing trial of labour after cesarean section(TOLAC)for a second pregnancy.Methods A retrospective analysis was conducted on clinical medical data from 138 pregnant women with TOLAC who were admitted to the hospital between January 2021 and December 2021.The pregnant women were divided into three groups based on the total amount of OT used during labor:low-dose group(61 cases),middle-dose group(45 cases),and high-dose group(32 cases).The study compared the progress of labor,coagulation function,labor mode,pregnancy outcomes,and perinatal outcomes among the three groups.Results There were no statistically significant differences in the duration of the first,second,third,and total stages of labour among the three groups(P>0.05).Compared to the pre-medication period,the three groups showed a statistically significant decrease in prothrombin time(PT)and activated partial thromboplastin time(APTT),as well as an increase in fibrinogen(FIB)levels after medication(P<0.05).However,there were no significant differences in PT,APTT,and FIB levels among the three groups after medication(P>0.05).The occurrence of placental abruption and neonatal hyperbilirubinaemia was lower in the small-dose and medium-dose groups compared to the high-dose group,and the difference was statistically significant(P<0.05).Conclusions Oxytocin(OT)can improve uterine contractility and coagulation function in pregnant women undergoing TOLAC.However,high doses of OT may increase the risk of placental abruption and neonatal hyperbilirubinemia.
关键词
缩宫素/剖宫产术后再次妊娠/阴道试产/凝血功能/母婴结局Key words
oxytocin/re-pregnancy after cesarean section/vaginal trial labor/coagulation function/maternal-infant out-comes引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据