产房中缩宫素应用的精细化管理与风险管控

金志珊; 赵茵

doi:10.19538/j.fk2026040102

PDF(960 KB)

中国实用妇科与产科杂志 ›› 2026, Vol. 42 ›› Issue (4) : 389-395. DOI: 10.19538/j.fk2026040102

专题笔谈

产房中缩宫素应用的精细化管理与风险管控

金志珊 ¹ ,
赵茵 ¹^,²

作者信息 +

Refined management and risk control in the use of oxytocin in delivery rooms

JIN Zhi-shan ¹ ,
ZHAO Yin ¹^,²

Author information +

文章历史 +

摘要

缩宫素作为产房中催引产的关键药物，在促进子宫收缩方面发挥着重要作用，但其使用需要精细化管理以确保母儿安全，避免子宫过度收缩及相关并发症的发生。文章系统综述了缩宫素的生理药理机制、不同给药方案的临床效果、监测技术、风险因素及其管控策略，结合最新的随机对照试验和观察性研究，重点探讨了缩宫素剂量调控、使用时机、个体化管理及多学科协作在降低剖宫产率、预防子宫破裂和产后出血中的应用价值。通过综合分析现有证据，文章旨在为产科临床实践提供循证指导，以促进缩宫素的安全有效使用，优化产房管理流程，提高母儿健康结局。

Abstract

Oxytocin plays a crucial role in the process of labor induction and augmentation by promoting uterine contractions. However，its administration requires refined management to ensure maternal and fetal safety and to avoid uterine tachysystole and related complications. This article systematically reviews the physiological and pharmacological mechanisms of oxytocin， clinical outcomes of different administration protocols， monitoring techniques， risk factors and corresponding control strategies. Incorporating the latest randomized controlled trials and observational studies，it focuses on the clinical value of oxytocin dose adjustment，timing of use，individualized management，and multidisciplinary collaboration in reducing cesarean section rates and preventing uterine rupture and postpartum hemorrhage. Through a comprehensive analysis of existing evidence，this paper aims to provide evidence-based guidance for clinical obstetric practice，promote the safe and effective use of oxytocin，optimize delivery room management protocols，and improve maternal and neonatal health outcomes.

导出引用

金志珊, 赵茵. 产房中缩宫素应用的精细化管理与风险管控[J]. 中国实用妇科与产科杂志. 2026, 42(4): 389-395 https://doi.org/10.19538/j.fk2026040102

JIN Zhi-shan, ZHAO Yin. Refined management and risk control in the use of oxytocin in delivery rooms[J]. Chinese Journal of Practical Gynecology and Obstetrics. 2026, 42(4): 389-395 https://doi.org/10.19538/j.fk2026040102

中图分类号： R714.1

参考文献

列表( 原文顺序 | 文献年度倒序 | 文中引用次数倒序 ) 可视化分析

[1]	Dale HH. On some physiological actions of ergot[J]. J Physiol, 1906, 34(3):163-206. DOI:10.1113/jphysiol.1906.sp001148. 本文引用 [1]

[2]	Du Vigneaud V, Ressler C, Trippett S. The sequence of amino acids in oxytocin,with a proposal for the structure of oxytocin[J]. J Biol Chem, 1953, 205(2):949-957. 本文引用 [1]

[3]	Uvnäs-Moberg K. The physiology and pharmacology of oxytocin in labor and in the peripartum period[J]. Am J Obstet Gynecol, 2024, 230(3S):S740-S758. DOI:10.1016/j.ajog.2023.04.011. 本文引用 [3]

[4]	Hermesch AC, Kernberg AS, Layoun VR, et al. Oxytocin: physiology, pharmacology,and clinical application for labor management[J]. Am J Obstet Gynecol, 2024, 230(3S):S729-S739. DOI:10.1016/j.ajog.2023.06.041. 本文引用 [4]

[5]	Maejima Y, Yokota S, Yamachi M, et al. Oxytocin enhances demethylation through tet enzyme expression in neurons of aged mice: oxytocin as a potential antiaging peptide[J]. Aging Cell, 2025, 24(10):e70198. DOI:10.1111/acel.70198. 本文引用 [1]

[6]	Heydenreich FM, Plouffe B, Rizk A, et al. Michaelis-menten quantification of ligand signaling bias applied to the promiscuous vasopressin V2 receptor[J]. Mol Pharmacol, 2022, 102(3):139-149. DOI:10.1124/molpharm.122.000497. 本文引用 [1]

[7]	Bekkenes ME, Jørgensen MM, Jacobsen AF, et al. Effects of prophylactic oxytocin or carbetocin on troponin release and postpartum haemorrhage at planned caesarean delivery: a double-blind randomised controlled trial[J]. BJOG, 2025, 132(12):1742-1752. DOI:10.1111/1471-0528.18312. 本文引用 [1]

[8]	Reddy UM, Sandoval GJ, Tita ATN, et al. Oxytocin regimen used for induction of labor and pregnancy outcomes[J]. Am J Obstet Gynecol MFM, 2024, 6(12):101508. DOI:10.1016/j.ajogmf.2024.101508. 本文引用 [3]

[9]	Wheeler V, Hoffman A, Bybel M. Cervical ripening and induction of labor[J]. Am Fam Physician, 2022, 105(2):177-186. 本文引用 [1]

[10]	Dubay R, Rentschler N, Jolly D, et al. Does adjunctive oxytocin infusion during balloon cervical ripening improve labor induction?[J]. J Fam Pract, 2022, 71(2):E18-E19. DOI:10.12788/jfp.0353. 本文引用 [2]

[11]	Wu XL, Liu HY, Xiang QH, et al. Double balloon combined with oxytocin in labor induction: analysis of multivariate factors affecting the efficacy of cervical ripening[J]. Int J Womens Health, 2024, 16:1219-1227. DOI:10.2147/IJWH.S460853. 本文引用 [1]

[12]	Gagnon J, Corlin T, Berghella V, et al. Intracervical Foley catheter with and without oxytocin for labor induction with Bishop score ≤3: a secondary analysis[J]. Am J Obstet Gynecol MFM, 2021, 3(4):100350. DOI:10.1016/j.ajogmf.2021.100350. 本文引用 [1]

[13]	Nkobetchou M, Ray CL, Girault A. Oral misoprostol versus vaginal dinoprostone for term labor induction among women requiring oxytocin before 4 cm: A secondary analysis of the STOPOXY trial[J]. Eur J Obstet Gynecol Reprod Biol, 2026, 316:114809. DOI:10.1016/j.ejogrb.2025.114809. 本文引用 [1]

[14]	Gulersen M, DiSturco M, Krantz DA, et al. Comparison of two management options for labor induction following unsuccessful prostaglandin E2 ripening[J]. J Matern Fetal Neonatal Med, 2022, 35(9):1759-1763. DOI:10.1080/14767058.2020.1769594. 本文引用 [1]

[15]	中华医学会妇产科学分会产科学组. 妊娠晚期促子宫颈成熟与引产指南(2024)[J]. 中华妇产科杂志, 2024, 59(11): 819-828. DOI:10.3760/cma.j.cn112141-20240707-00381. 本文引用 [2]

[16]	ACOG. First and Second Stage Labor Management: ACOG Clinical Practice Guideline No. 8[J]. Obstet Gynecol, 2024, 143(1):144-162. DOI:10.1097/AOG.0000000000005447. 本文引用 [1]

[17]	Logue TC, Zullo F, van Biema F, et al. High- vs low-dose oxytocin regimens for labor augmentation: a systematic review and meta-analysis[J]. Am J Obstet Gynecol MFM, 2025, 7(2):101604. DOI:10.1016/j.ajogmf.2025.101604. 本文引用 [3]

[18]	Grasch JL, Costantine MM, Cahill AG, et al. High- vs low-dose oxytocin protocols for labor induction: a systematic review and meta-analysis[J]. Am J Obstet Gynecol MFM, 2025, 7(7):101691. DOI:10.1016/j.ajogmf.2025.101691. 本文引用 [1]

[19]	Aboshama RA, Abdelhakim AM, Shareef MA, et al. High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials[J]. J Perinat Med, 2020; 49(2):178-190. DOI:10.1515/jpm-2020-0042. 本文引用 [1]

[20]	Moraes FCA, Kelly FA, Leite MGHSJ, et al. High-dose versus low-dose oxytocin for labor augmentation: a meta-analysis of randomized controlled trials[J]. J Pers Med, 2024, 14(7):724. DOI:10.3390/jpm14070724. 本文引用 [1]

[21]	Nunes I, Dupont C. European Guidelines on Perinatal Care - Oxytocin for induction and augmentation of labor[J]. J Matern Fetal Neonatal Med, 2022, 35(25):7166-7172. DOI:10.1080/14767058.2021.1945577. 本文引用 [4]

[22]	Adams AD, Coviello EM, Drassinower D. The effect of maternal obesity on oxytocin requirements to achieve vaginal delivery[J]. Am J Perinatol, 2020, 37(4):349-356. DOI:10.1055/s-0039-1694982. 本文引用 [1]

[23]	Wei RM, Bounthavong M, Hill MG. High- vs low-dose oxytocin in lean and obese women: a double-blinded randomized controlled trial[J]. Am J Obstet Gynecol MFM, 2022, 4(4):100627. DOI:10.1016/j.ajogmf.2022.100627. 本文引用 [1]

[24]	Tadesse T, Assefa N, Roba HS, et al. Failed induction of labor and associated factors among women undergoing induction at University of Gondar Specialized Hospital,Northwest Ethiopia[J]. BMC Pregnancy Childbirth, 2022, 22(1):175. DOI:10.1186/s12884-022-04476-7. 本文引用 [1]

[25]	Mundle S, Lightly K, Durocher J, et al. Oral misoprostol alone,compared with oral misoprostol followed by oxytocin,in women induced for hypertension of pregnancy: A multicentre randomised trial[J]. BJOG, 2024, 131(11):1532-1544. DOI:10.1111/1471-0528.17839. 本文引用 [1]

[26]	Camille O, Laura M, Mona M, et al. Comparison of oxytocin use between singleton and twin pregnancies during induction of labor: A multicenter case-control study[J]. Eur J Obstet Gynecol Reprod Biol, 2025, 306:25-28. DOI:10.1016/j.ejogrb.2024.12.045. 本文引用 [1]

[27]	邹馨逸, 李闯, 魏军. 双胎妊娠的孕期管理与分娩[J]. 中国实用妇科与产科杂志, 2025, 41(2):133-138. DOI:10.19538/j.fk2025020102. 本文引用 [1]

[28]	陈功立, 漆洪波. 产后出血的个体化处理[J]. 中国实用妇科与产科杂志, 2026, 42(1):40-43. DOI:10.19538/j.fk2026010110. 本文引用 [1]

[29]	王媛, 王谢桐. 产后出血的止血方法研究现状[J]. 中国实用妇科与产科杂志, 2024, 40(4):410-412. DOI:10.19538/j.fk2024040108. 本文引用 [1]

[30]	Boujenah J, Renassia S, Djafer R, et al. Effects of a policy for reasonable use of oxytocin during spontaneous labor at term[J]. Gynecol Obstet Fertil Senol, 2020, 48(9):657-664. DOI:10.1016/j.gofs.2020.03.018. 本文引用 [1]

[31]	Jafar U, Hassan U, Usama F, et al. Continued versus discontinued oxytocin in the active phase of induced labor in term pregnancies: an updated systematic review and meta-analysis of randomized controlled trials[J]. Gynecol Obstet Invest, 2026, 91(1):137-147. DOI:10.1159/000546438. 本文引用 [1]

[32]	Didier-Mathon H, Kayem G, Thubert T, et al. Risk factors for complete uterine rupture in patients with trial of labor after cesarean delivery[J]. Acta Obstet Gynecol Scand, 2025, 104(2):380-388. DOI:10.1111/aogs.15017. 本文引用 [2]

[33]	Secchi D, Albéric J, Gobillot S, et al. Balloon catheter vs oxytocin alone for induction of labor in women with one previous cesarean section and an unfavorable cervix: a multicenter,retrospective study[J]. Arch Gynecol Obstet, 2022, 306(2):379-387. DOI:10.1007/s00404-021-06298-y. 本文引用 [1]

[34]	Nicolì P, Gulersen M, Beacham J, et al. Oxytocin dosing during trial of labor after cesarean to minimize the risk of uterine rupture: a systematic review and meta-analysis[J]. Am J Obstet Gynecol MFM, 2026, 8(1):101846. DOI:10.1016/j.ajogmf.2025.101846. 本文引用 [2]

[35]	Zhu H, Lu D, Branch DW, et al. Oxytocin is not associated with postpartum hemorrhage in labor augmentation in a retrospective cohort study in the United States[J]. Am J Obstet Gynecol, 2024; 230(2):247.e1-247.e9. DOI:10.1016/j.ajog.2023.07.054. 本文引用 [1]

[36]	张盼盼, 周玮. 产程中子宫收缩的监测[J]. 中国实用妇科与产科杂志, 2024, 40(2):147-150. DOI:10.19538/j.fk2024020105. 本文引用 [1]

[37]	李磊, 王谢桐. 从临床救治再谈产科重症监护病房建设[J]. 中国实用妇科与产科杂志, 2024, 40(10):974-978. DOI:10.19538/j.fk2024100104. 本文引用 [1]

[38]	Vuelta-Arce M, Chiapella-Micó C, Mestre-Prad MT, et al. Comprehensive tackling to the safe handling of hazardous drugs: a multidisciplinary approach to clinical practice[J]. Int J Occup Med Environ Health, 2020, 33(5):621-634. DOI:10.13075/ijomeh.1896.01534. 本文引用 [1]

[39]	Qian X, Zhou B, Li P, Garfield RE, Liu H. Quantitative analysis for grading uterine electromyography activities during labor.[J] Am J Obstet Gynecol MFM, 2023, 5(2):100798. DOI:10.1016/j.ajogmf.2022.100798. 本文引用 [1]