Weekes Christopher R, Mahomed Kassam
Obstetrics and Gynaecology department, Nambour General Hospital, Nambour, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2010 Oct;50(5):428-31. doi: 10.1111/j.1479-828X.2010.01206.x.
Women with pre-labour rupture of membranes at term (Term-PROM) commonly choose to have early induction of labour with the use of oxytocin. Although there is evidence of efficacy and safety of induction by the use of prostaglandin, it is used infrequently in Australia.
To identify current practice and views of obstetricians in Australia, on Term-PROM.
A postal survey among all obstetricians in Australia in April 2009. Fellows no longer practising obstetrics or who were non-practising were asked to return the survey without completing it.
Of the 1319 surveys posted, 720 (54.6%) were returned, 23.8% of whom were practising only gynaecology or non-practising, leaving 548 respondents practising obstetrics (41.5%). The most common management of Term-PROM is induction of labour (IOL) within 24 h at the next convenient opportunity (75%). More than 96% would use intravenous oxytocin at some stage as their method of induction. Prostaglandin gel (PGE₂) was utilised by 15% of respondents regularly, mainly for ripening of an unfavourable cervix in a primigravida, but nearly 40% would consider the use of PGE₂ indicating that it would produce a more 'natural' labour, that women could ambulate more and that there would be reduced impact on midwifery staff. For those who would not consider PGE₂, the most common reasons were concerns of hyperstimulation, increased infection rate and precautions of use based on product information.
Oxytocin is the most widely used induction agent for women with term-PROM. PGE₂ is an important alternative method of induction and nearly 40% would consider using it. Clarification from RANZCOG and further studies on whether PGE₂ offers a safe and effective option are now required.
足月胎膜早破（Term-PROM）的女性通常选择使用缩宫素尽早引产。尽管有证据表明使用前列腺素引产有效且安全，但在澳大利亚其使用并不频繁。
确定澳大利亚产科医生对足月胎膜早破的当前做法和观点。
2009年4月对澳大利亚所有产科医生进行邮寄调查。不再从事产科工作或已不执业的会员被要求将调查问卷退回而无需填写。
在寄出的1319份调查问卷中，720份（54.6%）被退回，其中23.8%仅从事妇科工作或已不执业，剩下548名从事产科工作的受访者（41.5%）。足月胎膜早破最常见的处理方法是在下次方便时24小时内引产（75%）。超过96%的人会在某个阶段使用静脉缩宫素作为引产方法。15%的受访者经常使用前列腺素凝胶（PGE₂），主要用于初产妇宫颈条件不佳时的促宫颈成熟，但近40%的人会考虑使用PGE₂，表明它会使产程更“自然”，女性可以更多地走动，并且对助产人员的影响会更小。对于那些不考虑使用PGE₂的人，最常见的原因是担心子宫过度刺激、感染率增加以及基于产品信息的使用注意事项。
缩宫素是足月胎膜早破女性最广泛使用的引产药物。PGE₂是一种重要的替代引产方法，近40%的人会考虑使用它。现在需要澳大利亚和新西兰皇家妇产科医师学会进行明确说明，并进一步研究PGE₂是否提供了一种安全有效的选择。
