目的：比较地诺前列酮栓促宫颈成熟管理规范实施前后的妊娠结局，探讨其促宫颈成熟的安全性。方法：回顾分析2012年9月—2014年2月在同济大学附属第一妇婴保健院使用地诺前列酮栓促宫颈成熟并分娩的612例产妇的临床资料，2013年4月起地诺前列酮栓促宫颈成熟管理规范实施，通过比较管理规范实施前后的母婴结局及不良反应发生率，探讨其对妊娠结局的影响。结果：2013年4月管理规范实施前有449例产妇使用地诺前列酮栓促宫颈成熟，管理规范实施后有163例。共413例（67．5％）引产成功，管理规范实施后48 h内、24 h内及12 h内引产成功率均略低于规范实施前，但差异均无统计学意义。总剖宫产率为27．1％，管理规范实施前后剖宫产率差异无统计学意义。2组新生儿 Apgar评分及入住重症监护病房率差异均无统计学意义。规范实施后宫缩过频过强以及羊水粪染的发生率较规范实施前显著降低，差异有统计学意义（P＜0．05）；规范实施前后子宫过度刺激的发生率、绒毛膜羊膜炎可能的发生率差异无统计学意义。2组均无羊水栓塞和会阴严重裂伤并发症的发生。结论：地诺前列酮栓是比较安全有效的促宫颈成熟及引产的方法，管理规范的实施有助于保障母婴安全及减少不良妊娠结局发生。%Objective:To compare the pregnancy outcome before the implementation of management specification of cervical ripening with dinoprostone suppository with that after the implementation and explore its safety for cervical ripening .Methods:The clinical data of 612 puerperants ,who received cervical ripening with dinoprostone suppository and delivered in First Mater‐nal and Infant Hospital Affiliated to Tongji University during Sep 2012 and Feb 2014 ,were retrospectively analyzed .The man‐agement specification of cervical ripening with dinoprostone had been implemented since Apr 2013 .The maternal and neonatal outcomes ,as well as the rate of adverse reactions ,before and after the implementation of management specification of cervical ripening with dinoprostone suppository were compared with each other ,so as to explore its effects on pregnancy outcome .Re‐sults:There were 449 puerperants receiving cervical ripening with suppository before the implementation of management speci‐fication in Apr 2013 and 163 cases after that .Totally 413 cases(67 .5% ) were induced labour successfully .The success rates of inducting labor within 48 h ,24 h and 12 h after the implementation of management specification were lower than that before the implementation of management specification ,but there was no significant difference .The cesarean rate was 27 .1% and there was no statistically significant difference between the cesarean rate before the implementation of management specification and that after the implementation .There was no statistically significant difference in Apgar score and admission rate to ICU between the two groups .The incidence rates of tachysystole and hypertonus ,meconium‐stained amniotic fluid after the implementation of specification were significantly lower than that before the implementation ,and the difference was statistically significant(P<0 .05) .There was no statistically significant difference regarding the incidence rates of uterine hyperstimulation and the clinical chorioamnionitis .There was no occurrence of complications as amniotic fluid embolism and severe perineal laceration .Conclusions:Di‐noprostone suppository is a safe and effective method for cervical ripening and labor induction .The implementation of management speci‐fication is conducive to protecting maternal and infant and reducing the adverse pregnancy outcomes .
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