Mohr-Sasson Aya, Schiff Eyal, Sindel Ofra, Suday Ramy Rahamim, Kalter-Farber Anat, Mashiach Roy, Yinon Yoav, Dulitzki Moti, Sivan Eyal, Mazaki-Tovi Shali
a Department of Obstetrics and Gynecology , Sheba Medical Center , Tel-Hashomer , Israel and.
b Sackler School of Medicine, Tel Aviv University , Tel Aviv , Israel.
J Matern Fetal Neonatal Med. 2017 Sep;30(17):2074-2077. doi: 10.1080/14767058.2016.1236252. Epub 2016 Oct 6.
To determine the success rate of induction of labor (IOL) using Foley transcervical balloon (FTB) versus prostaglandin E (PGE) vaginal insert, following failure of cervical ripening with PGE vaginal insert.
A retrospective cohort study of all pregnant women admitted for IOL with either FTB or PGE vaginal insert. Either second dose of PGE vaginal insert or FTB was used as a second line treatment after failure (not giving birth in 24 h from insertion) of first PGE vaginal insert.
During the study period, 1162 women were admitted for IOL. Failure was reported in 322/852 (37.8%) in the FTB versus 162/310 (52.2%) in the PGE group (p < 0.001). Among 162 patients treated with PGE as first line who did not deliver after 24 h, 14 had spontaneous rupture of membranes, 15 underwent stripping and 42 were in still in active labor. The remainder were allocated to either second trial of PGE treatment (n = 58) or FTB (n = 33) with failure rate higher in the PGE group, not statistically significant (p = 0.23).
IOL with FTB was not superior to PGE vaginal insert for IOL following failure of cervical ripening with PGE vaginal insert.
在使用前列腺素E（PGE）阴道栓剂宫颈成熟失败后，比较使用Foley经宫颈球囊（FTB）与PGE阴道栓剂引产的成功率。
对所有因引产而入院并使用FTB或PGE阴道栓剂的孕妇进行回顾性队列研究。在首次PGE阴道栓剂引产失败（放置后24小时内未分娩）后，使用第二剂PGE阴道栓剂或FTB作为二线治疗。
在研究期间，1162名妇女因引产入院。FTB组322/852（37.8%）报告引产失败，而PGE组为162/310（52.2%）（p<0.001）。在162例一线使用PGE治疗且24小时后未分娩的患者中，14例胎膜自然破裂，15例进行了胎膜剥离，42例仍在活跃产程中。其余患者被分配到PGE治疗的第二次试验（n=58）或FTB（n=33），PGE组失败率更高，但无统计学意义（p=0.23）。
在PGE阴道栓剂宫颈成熟失败后的引产中，FTB引产并不优于PGE阴道栓剂引产。
