Mode of delivery in pregnant women with hypertensive disorders and unfavorable cervix following induction of labor with vaginal application of prostaglandin E2
Mode of delivery in pregnant women with hypertensive disorders and unfavorable cervix following induction of labor with vaginal application of prostaglandin E2
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DOI：
10.1111/j.0001-6349.2005.00681.x
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发表时间：
2005-07-01
影响因子：
4.3
通讯作者：
Bar, J
中科院分区：
文献类型：
--
作者：
Ben-Haroush, A;Yogev, Y;Bar, J
背景资料。我们的目的是评估妊娠高血压疾病和宫颈不良孕妇在临产或足月经阴道应用前列腺素E-2(PGE(2))引产后的分娩方式，并确定这些妇女经阴道分娩成功的预测因素。在一项回顾性病例对照研究中，将PGE(2)片引产的高血压孕妇(研究组，n=284)与择期引产组(组2，n=115)和自然临产正常的孕妇(组3，n=510)进行比较。研究组剖宫产率(25.3%)明显高于研究组(14.8%)和研究组(9%)。将未分娩妇女排除在研究组和对照组后，研究组(16.9%)和第二组(11.1%)的CS发生率相似。子痫前期妇女与慢性高血压或妊娠高血压综合征妇女的CS发生率相似。在Logistic回归模型中，未分娩、用前列腺素E(2)引产和母亲的年龄(而不是高血压疾病)与CSs的风险增加独立且显著相关。PGE(2)在大约75%患有高血压疾病和宫颈不良的患者中引产成功，显然没有严重的母婴并发症。引产本身，而不是妊娠期高血压疾病是CS的独立危险因素。
Background. Our aim was to evaluate the mode of delivery in pregnant women with hypertensive disorders and unfavorable cervix following induction of labor with vaginal application of prostaglandin E-2 (PGE(2)) near or at term, and to define the predictors of successful vaginal delivery in such women.Methods. In a retrospective case-controlled study, pregnant women with hypertension, who underwent labor induction with PGE(2) tablets (study group, n = 284), were compared with women, who underwent elective induction of labor (group 2, n = 115), and women with normal spontaneous onset of labor (group 3, n = 510).Results. The rate of cesarean section (CS) was significantly higher in the study group (25.3%) than in group 2 (14.8%) and in group 3 (9%). Exclusion of the nulliparous women from the study and control groups yielded similar CS rates in the study group (16.9%) and in group 2 (11.1%). Women with pre-eclampsia and the women with chronic hypertension or pregnancy-induced hypertension had similar rates of CS. In logistic regression model, nulliparity, induction of labor with PGE(2), and maternal age, but not hypertensive disorders, were independently and significantly associated with increased risk of CS.Conclusions. PGE(2) induction of labor is successful in approximately 75% of patients with hypertensive disorders and unfavorable cervix, with apparently no serious maternal or fetal complications. The induction of labor by itself, and not the hypertensive disorders in pregnancy, is independent risk factor for CS.