过期妊娠宫颈条件不佳时行引产的临床研究： Foley 导管序贯宫颈内口与单独应用米索前列醇的比较。

Induction of labor in prolonged pregnancy with unfavorable cervix: comparison of sequential intracervical Foley catheter-intravaginal misoprostol and intravaginal misoprostol alone.

机构信息

Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

出版信息

Arch Gynecol Obstet. 2012 Apr;285(4):967-71. doi: 10.1007/s00404-011-2094-4. Epub 2011 Oct 20.

DOI:10.1007/s00404-011-2094-4

PMID:22012248

Abstract

PURPOSE

To compare the outcome of induced labor at term using sequential intracervical Foley catheter with intravaginal misoprostol versus intravaginal misoprostol alone.

METHODS

A prospective matched case control study among parturient with prolonged pregnancy and unfavorable cervix at a tertiary hospital in Nigeria.

RESULTS

The study population was 100 with a mean age of 29.46 ± 3.88 years. Parturient with prior cervical priming using intracervical Foley catheter had significantly lower oxytocin augmentation of uterine contractions in labor (44 vs. 64%, P = 0.045), shorter mean insertion to active phase labor duration (233 ± 98 vs. 354 ± 154 min, P = 0.0001), shorter insertion to delivery interval (514 ± 175 vs. 627 ± 268, P = 0.014), more vaginal delivery <12 h (92.5 vs. 60%, P = 0.001) and less delivery by caesarean section (20 vs. 40%, P = 0.029).

CONCLUSIONS

The sequential combination of intracervical Foley catheter and intravaginal misoprostol for cervical ripening and induction of labor appears to be a safe and more effective method compared to intravaginal misoprostol in parturient at term with unfavorable cervices.

摘要

目的

比较经阴道序贯使用宫颈 Foley 导管与单独使用米索前列醇在足月引产中的效果。

方法

这是一项在尼日利亚一家三级医院进行的前瞻性匹配病例对照研究，纳入的对象为过期妊娠且宫颈条件不佳的产妇。

结果

本研究共纳入 100 例产妇，平均年龄为 29.46 ± 3.88 岁。与单纯使用米索前列醇相比，先前使用宫颈 Foley 导管行宫颈预处理的产妇在产程中催产素加强子宫收缩的比例明显更低（44% vs. 64%，P = 0.045），从宫颈导管插入到活跃期产程的平均时间更短（233 ± 98 分钟 vs. 354 ± 154 分钟，P = 0.0001），从宫颈导管插入到分娩的时间间隔更短（514 ± 175 分钟 vs. 627 ± 268 分钟，P = 0.014），<12 小时内阴道分娩的比例更高（92.5% vs. 60%，P = 0.001），剖宫产的比例更低（20% vs. 40%，P = 0.029）。