Cheng Shi-Yann, Hsue Chao-Song, Hwang Geen-Hour, Chen Walter, Li Tsai-Chung
Departments of Obstetrics and Gynecology, China Medical University Beigang Hospital, Yunlin, Taiwan.
J Obstet Gynaecol Res. 2010 Feb;36(1):72-8. doi: 10.1111/j.1447-0756.2009.01118.x.
To compare the outcomes of labor induction with oral misoprostol solution between nulliparous and multiparous women.
We retrospectively reviewed the medical records of all patients between 37 and 42 weeks of gestation with a Bishop score <or=6 who underwent labor induction with titrated oral misoprostol solution. The women were allocated into two groups: nulliparous and multiparous. The women received one basal unit of misoprostol solution (20 mL, 1 microg/mL) every hour for four doses; additional doses were titrated against individual uterine response. The interval of latent and active phase and vaginal delivery within 12 h were the primary outcomes.
Of the 112 women included in the study, 49 (43.8%) mulliparae and 63 (56.2%) multiparae underwent labor induction with titrated oral misoprostol solution. Complete vaginal delivery occurred within 12 h in 21 (42.9%) nulliparae and 54 (85.7%) multiparae (RR, 0.54; 95% CI, 0.39-0.76). All induction intervals, including the latent and active phases, were significantly shorter in the multiparous group (P < 0.01). Induction failure did not occur in any patient in either of the groups. There were no instances of hyperstimulation, which was defined as tachysystole or hypertonus with nonreassuring fetal heart rate pattern, although tachysystole, defined as the presence of at least six contractions in 10 min over at least two 10-min windows, occurred in four (8.2%) nulliparous women and in four (6.3%) multiparous women. Hypertonus, defined as a single contraction lasting more than 2 min, did not occur in either group. None of the neonates in either group had an Apgar score of <7 at 1 min.
Titrated oral misoprostol solution is a promising method of labor induction for both nulliparous and multiparous women.
比较初产妇和经产妇使用米索前列醇口服溶液引产的效果。
我们回顾性分析了孕周为37至42周、 Bishop评分≤6且接受米索前列醇口服溶液滴定引产的所有患者的病历。这些女性被分为两组：初产妇和经产妇。女性每小时接受一个基础单位的米索前列醇溶液（20 mL，1μg/mL），共四剂；额外剂量根据个体子宫反应进行滴定。潜伏期和活跃期的间隔以及12小时内的阴道分娩是主要结局。
在纳入研究的112名女性中，49名（43.8%）为初产妇，63名（56.2%）为经产妇接受了米索前列醇口服溶液滴定引产。21名（42.9%）初产妇和54名（85.7%）经产妇在12小时内完成了阴道分娩（RR，0.54；95%CI，0.39 - 0.76）。经产妇组的所有引产间隔，包括潜伏期和活跃期，均显著缩短（P < 0.01）。两组中均无患者引产失败。没有出现高刺激情况，高刺激定义为子宫收缩过速或张力过高且伴有胎儿心率异常，尽管子宫收缩过速（定义为在至少两个10分钟时段内10分钟内至少有六次宫缩）在4名（8.2%）初产妇和4名（6.3%）经产妇中出现。张力过高定义为单次宫缩持续超过2分钟，两组均未出现。两组中均无新生儿1分钟时Apgar评分<7分的情况。
米索前列醇口服溶液滴定法对初产妇和经产妇来说都是一种有前景的引产方法。
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