Sherman D J, Frenkel E, Pansky M, Caspi E, Bukovsky I, Langer R
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Obstet Gynecol. 2001 Mar;97(3):375-80. doi: 10.1016/s0029-7844(00)01168-6.
To compare extra-amniotic infusion of diluted prostaglandin (PG) E2 solution with saline infusion in balloon cervical ripening and labor induction.
Women with pregnancy complications and Bishop scores of 3 or lower (n = 116) were assigned randomly to receive extra-amniotic infusion (1 mL/minute) of normal saline or PGE2 in saline (0.5 microg/mL) through a Foley catheter with a 30-mL inflated balloon. We induced labor using intravenous oxytocin only when labor had not developed by 6 hours after balloon expulsion. Analysis was by intent-to-treat. We assessed ripening efficiency and course of labor in women who had spontaneous balloon expulsion (n = 110) and trial of labor (n = 107), respectively.
Ripening with PGE2 was associated with significantly shorter mean (+/- standard error of the mean [SEM]) time for balloon expulsion (4.7 +/- 0.4 versus 6.5 +/- 0.6 hours) and with significantly higher Bishop scores (P <.002), compared with ripening with saline. In the PGE2 group, rates of labor induction (15%) and oxytocin use (37%) were significantly lower than in the saline group (51% and 72%, respectively). The groups did not differ significantly in other labor abnormalities, labor duration, mode of delivery, birth weight, Apgar scores, and puerperal morbidity.
Cervical ripening by extra-amniotic balloon and PGE2 infusion is faster and more effective than by balloon and saline infusion, resulting in a higher rate of spontaneous labor and a lower rate of oxytocin use.
比较羊膜外输注稀释的前列腺素（PG）E2溶液与输注生理盐水用于宫颈成熟和引产的效果。
将116例患有妊娠并发症且 Bishop 评分≤3分的孕妇随机分为两组，通过带有30 mL充气球囊的Foley导管，以1 mL/分钟的速度羊膜外输注生理盐水或含PGE2（0.5μg/mL）的生理盐水。仅当球囊排出6小时后仍未发动宫缩时，才使用静脉缩宫素引产。按意向性分析。分别评估了自然排出球囊的110例孕妇和引产的107例孕妇的宫颈成熟效率和产程。
与输注生理盐水相比，PGE2促宫颈成熟时球囊排出的平均时间（±平均标准误[SEM]）显著缩短（4.7±0.4小时对6.5±0.6小时），Bishop评分显著更高（P<0.002）。PGE2组的引产率（15%）和缩宫素使用率（37%）显著低于生理盐水组（分别为51%和72%）。两组在其他产程异常、产程时长、分娩方式、出生体重、Apgar评分及产后发病率方面差异无统计学意义。
羊膜外球囊联合PGE2输注促宫颈成熟比球囊联合生理盐水输注更快、更有效，可提高自然分娩率并降低缩宫素使用率。
