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EFFECT OF AMNIOTOMY AND SPASMOLITIC TROSPIUM CHLORIDE ON UTERINE MUSCLE ELECTRICAL ACTIVITY DURING LABOR INDUCTION WITH OXYTOCIN AND PROSTAGLANDINS
Tibor Toth
orcid.org/0000-0001-7691-0332
; Opća bolnica Bjelovar, Odjel za ginekologiju i porodništvo
Sažetak
The aim of the study. To analyse the influence of amniotomy and spasmolytic trospium-chloride to electromyographical phenomena of myometrium during labor induced with oxytocine and prostaglandins. Study design. Myometrium electrical activity during labor induction was analysed in 110 gravidas hospitalized in Maternity Department of General Hospital in Bjelovar. Medium for labor induction at 54 pregnant patients was oxytocine infusion, at 20 intracervical prostaglandine (dinoprostone 0.5 mg), at 21 intravaginal prostaglandine (dinoprostone 2 mg) and at 15 pregnant women intravenous application of prostaglandine (dinoprostone 0.75 mg). Electromyographical measurement has been done after 30, 90, 150 and 270 minutes following the application of medium for labor induction. In all pregnancies before the starting of research there was electromiographycaly proved silence of uterus. Characteristics of electrical bursts were analysed separately (number of impulses, amplitudes, series, shape) and each record was merged by index of uterine activity according to Škrablin - Kučić formula: uterine activity index = number of impulse during 10 minute period + amplitude (µV) of highest potential divided by 100, by which the series of bursts were marked by aditional 20, biphasic waves with 2 and polyphasic with 3. It has been researched the influence of amniotomy and applied spasmolytics (trospium-chloride) to the values of electromyographical index of uterine activity (EMG IUA). Results. Amniotomy ¬during labor induced by oxitocine infusion causes statistically significant increase of EMG IUA value in comparison to pregnancies where no amniotomy has been done. Such increase exists in all three various cervix maturity groups (p<0.05). Statistically significant increase of EMG IUA after amniotomy has been noticed at application of intracervical prostaglandine form (dinoproston 0.5 mg), in comparison with other two prostaglandine forms (p<0.05). During research the need for applying spasmolytics (trospium chloride) because of cervical spasm has been four times more frequent at ¬induction with oxitocine in comparison with prostaglandine induction. The application of spasmolytic during oxitocine induction in cases with cervical spasm produced significant increase of EMG IUA in comparison with those where spasmolytic has not been used (p<0.05). The application of spasmolytic in cases with prostaglandine labor induction did not produce the statistically significant increase of EMG IUA (p>0.05). Conclusion. The registration of electro¬myographical activity before and after amniotomy or spasmolytic application during labor inductions is in positive correlation with a course and outcome of the labor. It may be useful in the monitoring and guidance of the labor.
Ključne riječi
induced labor; electrical uterine activity; amniotomy; spasmolitics; oxytocin; prostaglandins
Hrčak ID:
23290
URI
Datum izdavanja:
1.3.2007.
Posjeta: 3.276 *