Ghanaie Mandana Mansour, Jafarabadi Mina, Milani Forozan, Asgary Seyed Alaedin, Karkan Morteza Fallah
Reproductive Health Research center, Guilan University of Medical Sciences, Rasht, Iran.
Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Family Reprod Health. 2013 Jun;7(2):49-55.
The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction.
Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI) and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed.
From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients' demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001). The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05).rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001) and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05). The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05).there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity.
Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes.
本研究旨在进一步比较PGE2栓剂、宫颈 Foley 导管和羊膜腔外生理盐水灌注用于引产初产妇的疗效。
共368例单胎妊娠、头先露、胎膜完整且 Bishop 评分≤4分的初产妇被随机分为3组，分别为单纯Foley导管组、羊膜腔外生理盐水灌注（EASI）组和PGE2栓剂组。所有产妇均同时接受稀释缩宫素静脉滴注。评估 Bishop 评分的变化、产程进展、各种产程终点及分娩结局。
排除5例后，对363例产妇进行研究，其中119例被分配至EASI组，121例至Foley导管组，118例至PGE2栓剂组。三组患者的人口统计学特征及引产指征差异均无统计学意义（P = 0.0001）。EASI组引产6小时后Bishop评分有显著改善。EASI组进入活跃期的平均时间为357±135分钟，Foley导管组为457±178分钟，PGE2栓剂组为609±238分钟（P < 0.05）。EASI组胎膜自然破裂率更高（P = 0.0001），且EASI组从引产开始至胎膜自然破裂的平均时间短于其他组（P < 0.05）。EASI组阴道分娩的平均时间为14.8±6.1小时，Foley导管组为11.4±4.8小时，PGE2栓剂组为18.9±6.4小时（P < 0.05）。阿氏评分、新生儿平均出生体重及新生儿发病率方面无差异。
我们的研究表明，EASI联合缩宫素进行引产术前宫颈成熟在 Bishop 评分及各种产程终点和结局方面优于Foley导管和PGE2。
