2009年ACOG引产指南

2009年ACOG引产指南

2009年ACOG引产指南
CLINICAL MANAGEMENT GUIDELINES FOR OBSTETRICIAN–GYNECOLOGISTS
NUMBER 107, AUGUST 2009
Induction of Labor
引产术
More than 22% of all gravid women undergo induction of labor in the United States, and the overall rate of induction of labor in the United States has more than doubled since 1990 to 225 per 1,000 live births in 2006 (1). The goal of induction of labor is to achieve vaginal delivery by stimulating uterine contractions before the spontaneous onset of labor. Generally, induction of labor has merit as a therapeutic option when the benefits of expeditious delivery outweigh the risks of continuing the pregnancy. The benefits of labor induction must be weighed against the potential maternal and fetal risks associated with this procedure (2). The purpose of this document is to review current methods for cervical ripening and induction of labor and to summarize the effectiveness of these approaches based on appropriately conducted outcomes-based research. These practice guidelines classify the indications for and contraindications to induction of labor, describe the various agents used for cervical ripening, cite methods used to induce labor, and outline the requirements for the safe clinical use of the various methods of inducing labor.
在美国，大于22%的妊娠妇女要经历引产术，而且，美国截止2006年每1000例活产中已有225例引产，总引产率相比1990年翻了一倍还多。引产术是为了通过在自主宫缩之前刺激子宫收缩达到阴道分娩的目的。总的来说，引产术是当快速结束分娩的益处大于继续妊娠的风险时，作为一种治疗选择是有其优势的。引产的益处必须大过相关的母体和胎儿的潜在风险。该文献的目的是对当前宫颈成熟的方法、引产术做一综述，并在以效果为基础的研究的适当引导下，总结了这些方法的疗效。该实用指南对引产的适应证及禁忌证进行分类，描述了用于宫颈成熟的各种药物，引用了引产术的方法，并概括了临床各种安全引产术方法的要求。
Background
背景
In 1948, Theobald and associates described their use of the posterior pituitary extract, oxytocin, by intravenous drip for labor induction (3). Five years later, oxytocin was the first polypeptide hormone synthesized by du Vigneaud and associates (4). This synthetic polypeptide hormone has since been used to stimulate uterine contractions. Other methods used for induction of labor include membrane stripping, amniotomy, nipple stimulation, and administration of prostaglandin E analog
ues.
1948年，Theobald及其助手描述了他们将垂体后叶提取物，催产素，作为引产药静滴使用。五年后，催产素成为由du Vigneaud及其助手合成的第一种多肽激素。该合成多肽激素由此被用来刺激子宫收缩。其他引产术包括剥膜术、羊膜穿刺术、乳头刺激，和前列腺素E类似物的使用。

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