Wang Lina, Zheng Jianlan, Wang Wenyan, Fu Jingli, Hou Li
a Department of Obstetric , The People's Liberation Army 174th Clinical College of Anhui Medical University , Xiamen , P.R. China .
b Department of Ob/Gyn and Neonatal and Reproductive Medicine , The People's Liberation Army 174th Hospital , Xiamen , P.R. China .
J Matern Fetal Neonatal Med. 2016;29(8):1297-307. doi: 10.3109/14767058.2015.1046828. Epub 2015 Jun 11.
The purpose of this study was to compare the efficacy and safety of intravaginal misoprostol and the dinoprostone vaginal insert for labor induction at term.
PubMed, EMBASE, MEDLINE, CNKI, EBSCO and the Cochrane Library were searched for articles published in English language from 2000 to 2014, Using the keywords misoprostol, dinoprostone, labor induction.
Eight of 436 studies (1669 women) identified met the criteria for meta-analysis. We assigned a quality rating to each included article. The use of misoprostol showed less oxytocin augmentation when compared with dinoprostone (RR = 0.78, 95% CI = 0.67-0.90). There was no difference in the risk of tachysystole (RR = 1.18, 95% CI = 0.78-1.79), uterine hyperstimulation (RR = 1.24, 95% CI = 0.75-2.06), vaginal delivery within 24 h (RR = 1.10, 95% CI = 1.00-1.20), cesarean delivery (RR = 0.84, 95% CI = 0.56-1.24), Neonatal Intensive Care Unit admission (RR = 0.86, 95% CI = 0.58-1.28), Apgar scores <7 in 5 min (RR = 1.18, 95% CI = 0.39-3.63) between misoprostol and dinoprostone.
Misoprostol compared with dinoprostone appears to show less oxytocin augmentation for labor induction at term. The other outcomes of both drugs were similar. However, these findings were based on small-scale trials. Further studies assessing the effectiveness and safety of misoprostol and dinoprostone in selected groups of patients are warranted.
本研究旨在比较阴道用米索前列醇与地诺前列酮阴道栓剂足月引产的有效性和安全性。
检索PubMed、EMBASE、MEDLINE、CNKI、EBSCO和考克兰图书馆，查找2000年至2014年发表的英文文章，使用关键词米索前列醇、地诺前列酮、引产。
436项研究（1669名女性）中有8项符合荟萃分析标准。我们对每篇纳入文章进行了质量评级。与地诺前列酮相比，米索前列醇用于引产时催产素增加较少（相对危险度RR = 0.78，95%可信区间CI = 0.67 - 0.90）。在子宫收缩过速风险（RR = 1.18，95% CI = 0.78 - 1.79）、子宫过度刺激（RR = 1.24，95% CI = 0.75 - 2.06）、24小时内阴道分娩（RR = 1.10，95% CI = 1.00 - 1.20）、剖宫产（RR = 0.84，95% CI = 0.56 - 1.24）、新生儿重症监护病房收治（RR = 0.86，95% CI = 0.58 - 1.28）、5分钟时阿氏评分<7（RR = 1.18，95% CI = 0.39 - 3.63）方面，米索前列醇与地诺前列酮之间无差异。
与地诺前列酮相比，米索前列醇在足月引产时似乎催产素增加较少。两种药物的其他结局相似。然而，这些发现基于小规模试验。有必要进一步开展研究，评估米索前列醇和地诺前列酮在特定患者群体中的有效性和安全性。
