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巴西东南部一家三级医院使用米索前列醇引产的情况

Induction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil.

作者信息

Silva Tácito Augusto Godoy, Borges Júnior Luciano Eliziário, Tahan Luisa Almeida, Costa Taynná Ferreira Arantes, Magalhães Fernanda Oliveira, Peixoto Alberto Borges, Martins Wellington de Paula, Araujo Júnior Edward

机构信息

Mário Palmério Hospital Universitário, Universidade de Uberaba (UNIUBE), Uberaba, MG, Brazil.

Department of Obstetrics and Gynecology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2017 Oct;39(10):523-528. doi: 10.1055/s-0037-1604259. Epub 2017 Jul 12.

Abstract

To assess cases of labor induction with vaginal 25-µg tablets of misoprostol and maternal outcomes in a tertiary hospital in southeastern Brazil.  This was a retrospective cohort study of 412 pregnant women with indication for labor induction. Labor induction was performed with vaginal 25-µg tablets of misoprostol in pregnant women with Bishop scores < 6. Stepwise regression analysis was used to identify the factors present at the beginning of induction that could be used as predictors of successful labor induction.  A total of 69% of the pregnant women who underwent labor induction progressed to vaginal delivery, and 31% of the women progressed to cesarean section. One or two misoprostol tablets were used in 244 patients (59.2%). Of the 412 patients, 197 (47.8%) required oxytocin later on in the labor process, after induction with misoprostol. The stepwise regression analysis showed that only Bishop scores of 4 and 5 and previous vaginal delivery were independent factors with statistical significance in the prediction of successful vaginal labor induction (β = 0.23,  < 0.001, for a Bishop score of 4 and 5, and β = 0.22,  < 0.001, for previous vaginal delivery).  Higher Bishop scores and previous vaginal delivery were the best predictors of successful labor induction with vaginal 25-µg tablets of misoprostol.

摘要

评估在巴西东南部一家三级医院使用25微克米索前列醇阴道片引产的病例及产妇结局。  这是一项对412例有引产指征孕妇的回顾性队列研究。对Bishop评分<6的孕妇使用25微克米索前列醇阴道片进行引产。采用逐步回归分析来确定引产开始时存在的可作为引产成功预测指标的因素。  共有69%接受引产的孕妇进展为阴道分娩,31%的孕妇进展为剖宫产。244例患者(59.2%)使用了1片或2片米索前列醇。在412例患者中,197例(47.8%)在米索前列醇引产后宫缩过程中需要使用缩宫素。逐步回归分析显示,只有Bishop评分为4分和5分以及既往阴道分娩是预测阴道引产成功具有统计学意义的独立因素(Bishop评分为4分和5分时,β=0.23,<0.001;既往阴道分娩时,β=0.22,<0.001)。  较高的Bishop评分和既往阴道分娩是使用25微克米索前列醇阴道片引产成功的最佳预测指标。

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