Chen Wenhang, Xue Jing, Gaudet Laura, Walker Mark, Wen Shi Wu
Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Epidemiology, School of Public Health, Central South University, Changsha, China.
Int J Gynaecol Obstet. 2015 Jun;129(3):193-8. doi: 10.1016/j.ijgo.2015.01.005. Epub 2015 Mar 10.
The effectiveness of Foley catheter plus misoprostol for cervical ripening has not been convincingly shown in trials.
To summarize the evidence comparing Foley catheter plus misoprostol versus misoprostol alone for cervical ripening.
Embase, Medline, and Cochrane Collaboration databases were searched with the terms "Foley catheter," "misoprostol," "cervical ripening," and "labor induction."
Randomized controlled trials comparing the methods of cervical ripening for delivery of a viable fetus were included.
Study characteristics, quality, and outcomes were recorded. Random-effects models were used to combine data.
Eight trials were included, with 1153 patients overall. In a pooled analysis of seven high-quality studies, the combination group had a decreased time to delivery (mean difference -2.36 hours, 95% confidence interval [CI] -4.07 to -0.66; P=0.007). Risk of chorioamnionitis was significantly increased in the combination group (risk ratio [RR] 2.07, 95% CI 1.04-4.13; P=0.04), and that of tachysystole with fetal heart rate changes was decreased (RR 0.58, 95% CI 0.38-0.91; P=0.02). Frequency of cesarean did not differ (P=0.77).
The combined use of Foley catheter and misoprostol results in a reduced time to delivery, a reduced frequency tachysystole with fetal heart rate changes, and an increased incidence of chorioamnionitis.
在试验中，尚未令人信服地证明使用 Foley 导管联合米索前列醇促进宫颈成熟的有效性。
总结比较 Foley 导管联合米索前列醇与单独使用米索前列醇促进宫颈成熟的证据。
使用“Foley 导管”“米索前列醇”“宫颈成熟”和“引产”等术语检索 Embase、Medline 和 Cochrane 协作数据库。
纳入比较用于分娩活胎的宫颈成熟方法的随机对照试验。
记录研究特征、质量和结果。采用随机效应模型合并数据。
纳入八项试验，共 1153 例患者。在对七项高质量研究的汇总分析中，联合组的分娩时间缩短（平均差值 -2.36 小时，95% 置信区间 [CI] -4.07 至 -0.66；P = 0.007）。联合组绒毛膜羊膜炎的风险显著增加（风险比 [RR] 2.07，95% CI 1.04 - 4.13；P = 0.04），伴有胎儿心率变化的子宫收缩过速的风险降低（RR 0.58，95% CI 0.38 - 0.91；P = 0.02）。剖宫产频率无差异（P = 0.77）。
Foley 导管与米索前列醇联合使用可缩短分娩时间，降低伴有胎儿心率变化的子宫收缩过速的频率，并增加绒毛膜羊膜炎的发生率。
