Stenson David, Wallstrom Tove, Sjostrand Maria, Akerud Helena, Gemzell-Danielsson Kristina, Wiberg-Itzel Eva
a Department of Clinical Science and Education , Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital , Sweden .
b Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden , and.
J Matern Fetal Neonatal Med. 2016 Oct;29(20):3286-91. doi: 10.3109/14767058.2015.1123242. Epub 2015 Dec 23.
To evaluate the frequency of uterine rupture following induction of labor in women with a previous cesarean section. Misoprostol was compared to other methods of induction.
A retrospective cohort study of 208 women attempting induction of labor after one previous cesarean section. Delivery data were collected retrospectively and compared. Group 1(2009-2010) was compared with Group 2 (2012-2013). In Group 1, the main method of induction was vaginal PGE2 (prostaglandin-E2), amniotomy, oxytocin or a balloon catheter. In Group 2, the dominant method of induction was an oral solution of misoprostol.
frequency of uterine rupture in the two groups.
Nine cases (4.3%) of uterine rupture occurred. There was no significant difference in the frequency of uterine rupture following the change of method of induction from PGE2, amniotomy, oxytocin or mechanical dilatation with a balloon catheter to orally administered misoprostol (4.1 versus 4.6%, p = 0.9). All ruptures occurred in women with no prior vaginal delivery.
The shift to oral misoprostol as the primary method of induction in women with a previous cesarean section did not increase the frequency of uterine rupture in the cohort studied.
评估既往有剖宫产史的女性引产后宫破裂的发生率。将米索前列醇与其他引产方法进行比较。
对208例既往有一次剖宫产史且尝试引产的女性进行回顾性队列研究。回顾性收集分娩数据并进行比较。将第1组（2009 - 2010年）与第2组（2012 - 2013年）进行比较。在第1组中，主要引产方法为阴道用PGE2（前列腺素E2）、人工破膜、缩宫素或球囊导管。在第2组中，主要引产方法为米索前列醇口服溶液。
两组子宫破裂的发生率。
发生9例（4.3%）子宫破裂。引产方法从PGE2、人工破膜、缩宫素或球囊导管机械扩张改为米索前列醇口服后，子宫破裂发生率无显著差异（4.1%对4.6%，p = 0.9）。所有破裂均发生在既往无阴道分娩史的女性中。
在本研究队列中，既往有剖宫产史的女性将引产主要方法改为米索前列醇口服并未增加子宫破裂的发生率。
