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ID naloge: 26 Letnik: 1997 Predmet: ginekologija in porodništvo
Uspešnost indukcije poroda z oksitocinom
Avtor: Katja Kopriva, Tina Vipotnik
Mentor: prof. dr. Marjan Pajntar
IZHODIŠCA: Uspeh indukcije poroda z oksitocinskim preparatom je še vedno nepredvidljiv posebaj pri nezrelem maternicnem vratu. Nepredvidljiv je tako koncni uspeh, kot tudi cas trajanja poroda.
NAMEN: Iskali smo povezavo med casom trajanja poroda, zrelostjo maternicnega vratu in porabo oksitocina. Pri tem smo upoštevali tudi vpliv nekaterih zdravil na trajanje aktivne faze poroda.
METODE DELA: V študijo smo vkljucili 121 porodnic, katerih porod je bil induciran s predrtjem plodovega mehurja in oksitocinom. S pomocjo treh razlicnih statisticnih metod smo iskali povezanost dveh odvisnih spremenljivk: casa trajanja latentne in aktivne faze poroda z desetimi neodvisnimi spremenljivkami, izmed katerih jih pet opredeljuje zrelost maternicnega vratu, dve kolicino dodajanega oksitocina, tri pa dodajana zdravila.
REZULTATI: Latentna faza se z vsako dodatno tocko, ki doloca dilatacijo maternicnega vratu skrajša pri prvorodnicah za 61 min (P<.001 ), pri mnogorodnicah za 21 min (P<.01 ). Aktivna faza pri mnogorodnicah se z vsako dodatno tocko za dilatacijo matemicnega vratu, skrajša za 45 min (P<.01 ). Aktivna faza pri prvorodnicah se z vsako dodatno tocko, ki doloca višino glavice skrajša za 95 min (P<.05). Vecja poraba oksitocina/uro pri vseh porodnicah podaljša latentno (P<.001 ) in aktivno (P<.05) fazo poroda . Skupna poraba oksitocina je pri vseh porodnicah v negativni povezavi z dilatacijo maternicnega vratu (P<.001) in višino glavice (P<.05). Hioscin butilbromid (P<.01) in meperidin (P<.05) cas trajanja poroda pomembno podaljšata.
ZAKLJUCKI: Z raziskavo smo ugotovili, da so le nekatere lastnosti ocene zrelosti maternicnega vratu pomembno povezane s trajanjem posameznih faz poroda. Celotna poraba oksitocina je pomembno povezana z zrelostjo maternicnega vratu. Izmed uporabljenih zdravil na potek poroda pomembno vplivata spazmolitik hioscin butilbromid in analgetik meperidin.
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[Abstract / English version]
The success rate of labour induction with oxytocin
Author: Katja Kopriva, Tina Vipotnik
Mentor: prof. dr. Marjan Pajntar
BACKGROUND: The success of labour induction with oxytocin is still unpredictable, particularly with an immature uterine cervix. The final result as well as the time of labour are unpredictable.
AIMS: In this research the correlation between the time of labour, uterine cervix maturity and the quantity of administered oxytocin was being investigated. The influence of certain drugs on the duration of active phase of labour was also taken into consideration.
PATIENTS AND METHODS: In a prospective study 121 women in labour whose labour was artificially induced with perforation of the amnion and oxytocin administration, were included. The correlation between two dependent variables (the latent and active phase of labour), and ten independent variables (five defining the properties of the Bishop score, two defining the quantity of administered oxytocin and three defining the applied drugs) was investigated by means of three different statistical methods.
RESULTS: The latent phase of labour shortens with each additional point determining the dilatation of cervix, in primiparous women for 61 min (P<.001) and in multiparous for ? 1 min (p<.Ol ). The duration of the active phase in multiparous women shortens with each additional point determining the dilatation of cervix for 45 min (P<.Ol ). The active phase in primiparous women shortens with each additional point determining the station for 95 min (P<.05). Higher dosage of oxytocin/h extends the latent (P<.001) and the active (P<.05) phase. Total dosage of oxytocin is negatively correlated with the dilatation (P<.001) and station (P<.05). Hyoscine butylbromide (P<.01 ) and meperidine (P<.05) extend the duration of labour.
CONCLUSIONS: The duration of the two phases of labour is significantly influenced by some properties of uterine cervix maturity. Total dosage of oxytocin is significantly correlated to the uterine cervix maturity. Spasmolytic drug hyoscine butylbromide and analgetic meperidine have a significant influence on the duration of labour as well.
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