Randomised trial of intravaginal misoprostol and intracervical Foley catheter for cervical ripening and induction of labour.
Randomised trial of intravaginal misoprostol and intracervical Foley catheter for cervical ripening and induction of labour.
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DOI：
10.1080/01443610500231450
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发表时间：
2005-08-01
期刊：
影响因子：
--
通讯作者：
Ogunlola, I O
中科院分区：
文献类型：
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作者：
Owolabi, A T;Kuti, O;Ogunlola, I O
尽管宫颈未成熟，仍可引产。本研究的目的是比较阴道内米索前列醇和宫颈内Foley球囊导管用于诱导前宫颈成熟和引产的安全性和有效性。共有120例宫颈不利（Bishop评分<或=4）需要引产的患者被前瞻性随机分组，每6小时接受50杯阴道内米索前列醇，最多两剂，或宫颈内Foley球囊导管12小时，然后静脉输注催产素。研究的两组在产妇年龄、胎次、胎龄、引产指征和初始Bishop评分方面具有可比性。两组患者的Bishop’s评分差异有统计学意义（分别为5.9 +/- 0.2和4.0 +/- 0.2,p < 0.001），但组间差异无统计学意义。导管组催产素诱导或助产的发生率（95%）高于米索前列醇组（43.3%）（p < 0.0001）。米索前列醇组诱导分娩间隔明显短于导管组（8.7 +/- 2.4 h vs 11.9 +/- 2.7 h p < 0.0001）。两组患者剖宫产率及其他手术分娩率无显著差异。米索前列醇组心动过速和过度刺激发生率高于导管组（p < 0.03）。两组间的胎便通过、1或5分钟Apgar评分< 7和进入新生儿重症监护病房的情况均无差异。总之，本研究的产妇和围产期结局没有差异，证实了两种方法的有效性和安全性，但我们观察到米索前列醇用于此目的时诱导至分娩间隔缩短。
Induction of labour may be indicated despite an unripe cervix. The purpose of this study was to compare the safety and efficacy of intravaginal misoprostol and an intracervical Foley's balloon catheter for preinduction cervical ripening and labour induction. A total of 120 patients requiring indicated induction of labour with an unfavourable cervix (Bishop's score < or =4) were randomised prospectively to receive either 50 mug intravaginal misoprostol every 6 h for a maximum of two doses, or an intracervical Foley balloon catheter for 12 h followed by an intravenous oxytocin infusion. The two arms of the study were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop's scores. There were significant change in the Bishop's score in the two groups (5.9 +/- 0.2 and 4.0 +/- 0.2, respectively, p < 0.001) but no inter group differences. Oxytocin induction or augmentation of labour occurred more in the catheter group (95%) than in the misoprostol group (43.3%) (p < 0.0001). Induction to delivery interval was significantly shorter in the misoprostol group than in the catheter group (8.7 +/- 2.4 vs 11.9 +/- 2.7 h p < 0.0001). There was no significant difference noted in the caesarean or other operative delivery rates among patients in the two treatment groups. There was a higher incidence of tachysystole and hyperstimulation in the misoprostol group than in the catheter group (p < 0.03). No differences were observed between groups for meconium passage, 1- or 5-min Apgar scores < 7 and admission into the neonatal intensive care unit. In conclusion, the maternal and perinatal outcomes in this study have shown no difference confirming the efficacy and safety of both methods, however we observe a decrease in the induction-to-delivery interval when misoprostol is used for this purpose.