A Randomized Clinical Trial Comparing Vaginal Misoprostol versus Cervical Foley Plus Oral Misoprostol for Cervical Ripening and Labor Induction
A Randomized Clinical Trial Comparing Vaginal Misoprostol versus Cervical Foley Plus Oral Misoprostol for Cervical Ripening and Labor Induction
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DOI：
10.1055/s-0028-1091396
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发表时间：
2009-01-01
影响因子：
2
通讯作者：
Martin, James N., Jr.
中科院分区：
文献类型：
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作者：
Hill, James B.;Thigpen, Brad D.;Martin, James N., Jr.
我们比较了阴道米索前列醇引产与宫颈上弗利导管和口服米索前列醇引产的情况。妊娠≥ 24 周的单胎妊娠被随机分配，初始剂量为 25 μg 阴道内米索前列醇，随后每隔 3 至 6 小时阴道内给予 50 μg 剂量，或宫颈上福利球囊和每隔 4 至 6 小时口服 100 μg 米索前列醇。主要结果是从引产到分娩的时间。 126 名女性随机接受单独阴道米索前列醇治疗（第一组），106 名女性接受 Foley 联合口服米索前列醇治疗（第二组）。各组在年龄、体重、胎龄、产次、引产指征和催产素使用方面相似。剖宫产率为 37%，剖宫产指征相似 (p=0.25)。 II 组从引产到分娩的时间（12.9 小时）显着短于 I 组（17.8 小时，p < 0.001）。阴道米索前列醇组子宫收缩过速的发生率较低（21% vs 39%，p=0.015）。与阴道米索前列醇相比，使用 Foley 球囊和口服米索前列醇在 24 小时内分娩的可能性明显更高。两组特布他林的使用和围产期结局相似。
We compared labor induced by vaginal misoprostol versus a supracervical Foley catheter and oral misoprostol. Singleton pregnancies at >= 24 weeks' gestation were randomized to either an initial 25-mu g dose of intravaginal misoprostol, followed by 50-mu g intravaginal doses at 3- to 6-hour intervals, or a supracervical Foley balloon and 100 mu g of oral misoprostol at 4- to 6-hour intervals. Primary outcome was time from induction to delivery. One hundred twenty-six women were randomized to vaginal misoprostol alone (group I) and 106 women to Foley and oral misoprostol (group II). The groups were similar in age, weight, gestational age, parity, indication for induction of labor, and oxytocin use. Cesarean delivery rates at 37% and cesarean indications were similar (p=0.25). The time from induction to delivery in group II (12.9 hours) was significantly shorter than that in group I (17.8 hours, p < 0.001). Uterine tachysystole occurred less often in the vaginal misoprostol group (21% versus 39%, p=0.015). Compared with vaginal misoprostol, delivery within 24 hours was significantly more likely with a Foley balloon and oral misoprostol. The use of terbutaline and peripartum outcomes were similar in the two groups.