陣痛に関する臨床的研究 (主として, トコグラムについて)

抄録

Employing Lorand's tocograph, the curves of labor pains were classified into a total of 17 wave types including 10 standard ones and observation were made on the onset of labor pains, intervals, wave types, frequency of pains and the power of contraction. Further, observations were also made on the weak pains, the influence of natural and synthetic oxytocin, quinine hydrochloride, methylergometrine, Buscopan, sex hormones, sugars etc as well as on the oxytocin sensitivity test of the uterus.
As for the wave types of normal labor, the majority showed VI-X type in the first stage of delivery, I-III type in the second stage of delivery, and X type in the third stage of delivery, namely, puerperium. The duration of labor pains was gradually prolonged from the initial stage toward the terminal stage of the first stage of delivery, but in the second stage of delivery, this period became shorter than that at the terminal stage of the first stage of delivery. And, moreover, intervals being shortened gradually, the frequency of pains was doubled in the second stage of delivery in comparison with that of the initial stage of the first stage of delivery. The power of contraction too was enhanced gradually from the first stage to the second stage of delivery.
As for the relationship between the tocogram and the period of delivery, the majority showed I₁ type and the mean period of the second stage of delivery was the shortest.
The wave types of weak pains were irregular in most cases. The period of labor pains too was shorter with longer intervals than that of normal delivery.
Those who received natural oxytocin showed no particular difference in the curves of labor pains, but their period of labor pains was prolonged and the frequency was enhanced. When intravenous drop injection was applied, the injection of 40 drops per hour was found to be most effective. Findings of synthesized oxytocin were the same. In the case of quinine hydrochloride, the administration of the 2 doses of 0.25 gr was superior than that of a single dose. Use of methyl-ergometrine in the third stage of delivery could shorten the period of the third stage of delivery. Use of Buscopan during the period of delivery caused temporary weakening of the labor pains but shortened the period of delivery as a whole. Use of Estrogen on the pregnant women whose term had already been expired failed to show any remarkable effects. Use of Progesterone produced the temporary weakening of the labor pains. Immediately after the use of sugar during the period of delivery caused the temporary weakening of th labor pains lasting only for 10 minutes or so, but afterwards they became stronger than befor administration.
Nixon and Smith's sensitivity test was applied on 20 cases, of which 12 cases were in agreement with the table of Nixon and Smith. This test, therefore, is considered to be a reasonable method for the prediction of the beginning of delivery.