Adeniji A O, Olayemi O, Odukogbe A A, Aimakhu C O, Oladokun A, Akindele F O, Adeniji O I, Omigbodun A O, Ilesanmi A O
Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria.
Afr J Med Med Sci. 2005 Dec;34(4):377-82.
The study compares the changes in the cervical factors in pre-induction cervical ripening with both transcervical Foley catheter and Intravaginal Misoprostol. This was a randomised prospective study of pregnant women, with singleton gestations who presented for antenatal care and delivery at a tertiary health institution in the South-western Nigeria between 1st March 2003 and 31st March 2004. One hundred and two (102) patients received 50microg intravaginal Misoprostol and Ninety-six (96) received size 16F Transcervical Foley catheters. Both groups were similar at the baseline. Misoprostol group showed greater improvement in the final cervical length score, with 38.4% and 58.6% scoring 2 and 3 respectively, in contrast with the Foley catheter group where 77.7% had final score of 1, with only 16% scoring 2 and none scored 3 (P = 0.00). Ninety-one percent of the patients in the misoprostol group achieved the maximum cervical consistency score of 2, contrasting with the 31.9% in the Foley Catheter group (P = 0.00). 64.9% of the patients in the Foley catheter group did not achieve appreciable change in cervical consistency. Our findings indicate that intravaginal misoprostol was more effective in improving the scores of cervical length and consistency, while transcervical Foley catheter was better at improving the cervical os dilatation score at pre-induction cervical ripening. The clinical implication is that, patients for pre-induction cervical ripening can be selected for either of these ripening agents based on which cervical factors require improvement in scores
本研究比较了经宫颈放置福莱导尿管和阴道使用米索前列醇进行引产术前宫颈成熟时宫颈因素的变化。这是一项对尼日利亚西南部一家三级医疗机构中接受产前护理和分娩的单胎妊娠孕妇进行的随机前瞻性研究。研究时间为2003年3月1日至2004年3月31日。102例患者接受了50微克阴道用米索前列醇，96例患者接受了16F型号的经宫颈福莱导尿管。两组在基线时相似。米索前列醇组在最终宫颈长度评分上改善更大，分别有38.4%和58.6%的患者评分为2分和3分，相比之下，福莱导尿管组77.7%的患者最终评分为1分，只有16%的患者评分为2分，无人评分为3分（P = 0.00）。米索前列醇组91%的患者达到了最大宫颈硬度评分为2分，而福莱导尿管组为31.9%（P = 0.00）。福莱导尿管组64.9%的患者宫颈硬度没有明显变化。我们的研究结果表明，阴道用米索前列醇在改善宫颈长度和硬度评分方面更有效，而经宫颈福莱导尿管在引产术前宫颈成熟时改善宫颈口扩张评分方面更好。临床意义在于，对于引产术前宫颈成熟的患者，可以根据需要改善评分的宫颈因素选择这些成熟药物中的任何一种。
