Duro Gómez Jorge, Garrido Oyarzún María Fernanda, Rodríguez Marín Ana Belén, de la Torre González Antonio Jesús, Arjona Berral José Eduardo, Castelo-Branco Camil
Hospital Universitario Reina Sofía, Córdoba, Spain.
Clínica Universidad de los Andes, Santiago de Chile, Chile.
J Obstet Gynaecol Res. 2017 Jan;43(1):87-91. doi: 10.1111/jog.13193. Epub 2016 Dec 8.
The aim of this study was to compare vaginal misoprostol with the Cook cervical ripening balloon (CCRB) for induction of labor in late-term nulliparous women.
This open, quasi-experimental, prospective study included 109 nulliparous women with late-term pregnancies and Bishop scores < 7. Fifty-five women were allocated to receive vaginal misoprostol 25 mcg and 54 received the CCRB to induce labor. The primary outcome was the time until delivery. Secondary outcomes included time to the onset of labor and obstetric and perinatal outcomes.
Women in the misoprostol group experienced shorter time until delivery (25.41 h vs 31.26 h; P < 0.01) and in a greater percentage gave birth within the first 24 h. Time to active stage of labor was 19.5 h and 23.8 h (P < 0.01) for misoprostol and the CCRB, respectively. There were no differences in the rates of cesarean section or post-partum anemia. Additionally, there were no differences in rates of tachysystolia, intrapartum fever, or meconium. Perinatal outcomes, post-partum pH, Apgar scores, and neonatal admissions were similar in the two groups.
Misoprostol 25 mcg reduces labor induction time compared with the CCRB with similar safety in late-term pregnancies.
本研究旨在比较阴道用米索前列醇与库克宫颈扩张球囊（CCRB）用于晚期未产妇引产的效果。
这项开放性、准实验性前瞻性研究纳入了109例晚期妊娠且 Bishop 评分<7分的未产妇。55例妇女被分配接受25微克阴道用米索前列醇，54例接受CCRB引产。主要结局是至分娩的时间。次要结局包括临产开始时间以及产科和围产期结局。
米索前列醇组妇女至分娩的时间较短（25.41小时对31.26小时；P<0.01），且更大比例的妇女在24小时内分娩。米索前列醇组和CCRB组进入活跃期的时间分别为19.5小时和23.8小时（P<0.01）。剖宫产率或产后贫血发生率无差异。此外，子宫收缩过速、产时发热或胎粪排出率也无差异。两组围产期结局、产后pH值、阿氏评分和新生儿入院情况相似。
与CCRB相比，25微克米索前列醇可缩短晚期妊娠引产时间，且安全性相似。
