Burgos Jorge, Arana Itziar, Garitano Ignacio, Rodríguez Leire, Cobos Patricia, Osuna Carmen, Del Mar Centeno María, Fernández-Llebrez Luis
Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces, C/Plaza de Cruces 12, 48903, Baracaldo, Biscay.
University of the Basque Country (UPV/EHU), Biscay.
J Perinat Med. 2017 Apr 1;45(3):299-303. doi: 10.1515/jpm-2015-0426.
To compare the outcome of two methods of labor induction and spontaneous onset of labor in breech presentation at term.
A retrospective study between 2003 and 2012. We compare obstetric (indication of induction, Bishop score, cesarean rate) and perinatal outcomes (Apgar score, umbilical artery pH, base excess ≤-12 mmol/L, admission to neonatal unit) between prostaglandins and oxytocin. We also compare labor induction versus spontaneous onset of labor.
Of the 1684 breech deliveries, we carried out labor induction in 221 cases (76% with prostaglandins, 24% with oxytocin). The prostaglandins group had significantly lower Bishop scores and the time for induction phase was significantly higher. There were no differences in cesarean rate between both methods of induction or spontaneous onset of labor. The prostaglandins group had higher rates of base excess ≤-12 mmol/L. Compared with spontaneous onset of labor in breech presentation, induction had significant lower rates of newborn weight and higher rates of admission to the neonatal unit.
Induction of labor in breech presentation at term is a reasonable and effective option after a careful selection of cases. It was not associated with an increase of perinatal morbidity or cesarean rate compared with spontaneous onset of labor.
比较足月臀位分娩时两种引产方法与自然发动分娩的结局。
一项2003年至2012年的回顾性研究。我们比较了使用前列腺素和缩宫素时的产科情况（引产指征、Bishop评分、剖宫产率）及围产期结局（阿氏评分、脐动脉pH值、碱剩余≤-12 mmol/L、入住新生儿病房情况）。我们还比较了引产与自然发动分娩的情况。
在1684例臀位分娩中，我们对221例进行了引产（76%使用前列腺素，24%使用缩宫素）。前列腺素组的Bishop评分显著更低，引产阶段的时间显著更长。两种引产方法与自然发动分娩的剖宫产率并无差异。前列腺素组碱剩余≤-12 mmol/L的发生率更高。与臀位自然发动分娩相比，引产的新生儿体重发生率显著更低，入住新生儿病房的发生率更高。
足月臀位引产在仔细选择病例后是一种合理且有效的选择。与自然发动分娩相比，它不会增加围产期发病率或剖宫产率。
