Melamed Nir, Ben-Haroush Avi, Kremer Shay, Hod Moshe, Yogev Yariv
Sackler Faculty of Medicine, Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Tel Aviv University, Petah-Tiqva, Israel.
J Matern Fetal Neonatal Med. 2010 Jun;23(6):536-40. doi: 10.3109/14767050903197076.
To identify factors predicting failure of cervical ripening with prostaglandin E(2) (PGE(2)).
A retrospective, cohort study of all women admitted for preinduction cervical ripening and failed to respond to PGE(2) in comparison with randomly selected control group of women who underwent successful preinduction cervical ripening with PGE(2) in a 3:1 ratio.
Overall 488 women were included, of them, 122 in the study group and 366 in the control group. A comparison between the two groups has revealed that maternal age above 30 years (OR = 2.7, 95%-CI 1.3-5.6), nulliparity (OR = 4.1, 95%-CI 1.7-10.0), prepregnancy BMI above 25 kg/m(2) (OR = 3.5, 95%-CI 1.7-7.1), cervical dilatation of 1 cm (OR = 9.1, 95%-CI 3.5-13.4), cervical effacement of 50% or less admission (OR = 5.0, 95%-CI 2.2-8.8), and gestational age of 37 weeks or less (OR = 2.9, 95%-CI 1.3-6.6), are independent and significant predictors of cervical ripening failure with PGE(2), and account for almost 50% of the variation in ripening outcome (R(2) = 0.47). No association was found between the risk of cervical ripening failure and the indication for ripening, rupture of membranes, weight gain during pregnancy, weight before labor, diabetes or preeclampsia during pregnancy, and the newborn weight.
Characterization of women who have a high probability for cervical ripening failure with PGE(2) will help to improve consultation and may help choosing the optimal method for labor induction in these cases.
确定预测前列腺素E2（PGE2）促宫颈成熟失败的因素。
一项回顾性队列研究，纳入所有因引产前行促宫颈成熟但对PGE2无反应的女性，并与随机选择的成功使用PGE2进行引产术前促宫颈成熟的女性对照组按3:1的比例进行比较。
共纳入488名女性，其中研究组122名，对照组366名。两组比较显示，母亲年龄大于30岁（OR = 2.7，95%可信区间1.3 - 5.6）、未生育（OR = 4.1，95%可信区间1.7 - 10.0）、孕前体重指数大于25 kg/m²（OR = 3.5，95%可信区间1.7 - 7.1）、宫颈扩张1 cm（OR = 9.1，95%可信区间3.5 - 13.4）、入院时宫颈消退50%或更少（OR = 5.0，95%可信区间2.2 - 8.8）以及孕周37周或更小（OR = 2.9，95%可信区间1.3 - 6.6）是PGE2促宫颈成熟失败的独立且显著的预测因素，几乎占成熟结局变异的50%（R² = 0.47）。未发现促宫颈成熟失败风险与成熟指征、胎膜破裂、孕期体重增加、临产前体重、孕期糖尿病或先兆子痫以及新生儿体重之间存在关联。
明确PGE2促宫颈成熟失败可能性高的女性特征将有助于改善咨询，并可能有助于为这些病例选择最佳引产方法。
