Navve D, Orenstein N, Ribak R, Daykan Y, Shechter-Maor G, Biron-Shental T
Department of Obstetrics and Gynecology, 'Meir Medical Center', Kfar Saba, Israel.
Sackler School of Medicine, Tel Aviv University, Kfar Saba, Israel.
J Perinatol. 2017 May;37(5):480-483. doi: 10.1038/jp.2016.260. Epub 2017 Feb 9.
To determine whether the Bishop-score upon admission effects mode of delivery, maternal or neonatal outcomes of labor induction in multiparous women.
A retrospective study including 600 multiparous women with a singleton pregnancy, 34 gestational weeks and above who underwent labor induction for maternal, fetal or combined indications. Induction was performed with one of three methods- oxytocin, a slow release vaginal prostaglandin E2 insert (10 mg dinoprostone) or a transcervical double balloon catheter. The women were divided into two groups-Bishop-score <6 and Bishop-score ⩾6. We evaluated labor course, maternal complications (postpartum hemorrhage, manual lysis, uterine revision, perineal tear grade 3-4, need for blood transfusions, relaparotomy, prolonged hospitalization) and neonatal outcomes (Apgar score, cord pH, hospitalization in the neonatal intensive care unit, prolonged hospitalization).
Both groups had a high rate of vaginal deliveries-93.7% and 94.9%, respectively. There was no difference between the two groups in terms of maternal or neonatal outcomes.
Labor induction in multiparous women is safe and successful regardless of the initial Bishop-score. In multiparous women the Bishop-score is not a good predictor for the success of labor induction, nor is it a predictor for maternal of neonatal adverse outcomes and complications.
确定多胎妊娠妇女入院时的 Bishop 评分是否会影响引产的分娩方式、母体或新生儿结局。
一项回顾性研究，纳入 600 名单胎妊娠、孕周 34 周及以上、因母体、胎儿或综合指征接受引产的多胎妊娠妇女。引产采用三种方法之一进行——缩宫素、缓释阴道前列腺素 E2 栓剂（10 mg 地诺前列酮）或经宫颈双球囊导管。将这些妇女分为两组——Bishop 评分<6 分和 Bishop 评分⩾6 分。我们评估了产程、母体并发症（产后出血、徒手剥离胎盘、子宫修复、3-4 度会阴裂伤、输血需求、再次剖腹手术、住院时间延长）和新生儿结局（阿氏评分、脐血 pH 值、入住新生儿重症监护病房、住院时间延长）。
两组阴道分娩率均较高，分别为 93.7%和 94.9%。两组在母体或新生儿结局方面无差异。
无论初始 Bishop 评分如何，多胎妊娠妇女引产都是安全且成功的。对于多胎妊娠妇女，Bishop 评分不是引产成功的良好预测指标，也不是母体或新生儿不良结局及并发症的预测指标。
