Mahomed Kassam, Wild Kellie, Weekes Christopher R
Department of Obstetrics and Gynaecology, Ipswich Hospital and University of Queensland, Ipswich, Australia.
Department of Obstetrics and Gynaecology, Ipswich Hospital, Ipswich, Australia.
Aust N Z J Obstet Gynaecol. 2018 Dec;58(6):654-659. doi: 10.1111/ajo.12788. Epub 2018 Feb 22.
Pre-labour rupture of membranes (PROM) at term is a common event with early induction of labour reducing infectious morbidity without increasing the caesarean rate. Syntocinon is commonly used for induction but prostaglandins are also routinely used. Large studies have shown no difference in the maternal and neonatal outcomes with either method.
To assess the safety and efficacy of vaginal prostaglandin (PG) compared to syntocinon for induction of labour in term-PROM.
This was a single-centre randomised controlled trial at Ipswich Hospital of women presenting at ≥37 weeks gestation with PROM. Women were randomised and managed in labour as per local guidelines. Analysis was by intention to treat.
One hundred and eighty-four women were recruited, 90 in the PG group and 94 in the oxytocin group. Women in both arms were of similar demographics and 53% of women in the PG group did not require any oxytocin. There was a statistically significant lower incidence of fetal heart rate abnormality in the PG group, 4.4% versus 12.8%. There was no difference in epidural use, caesarean section, maternal infection, admission to special care nursery or neonatal sepsis. Time to onset of labour was significantly longer in the PG group, 25.7 h versus 19.7 h but with no difference in the length of first stage. Maternal satisfaction was high in both groups with no significant difference in breastfeeding rates.
Induction of labour with oxytocin or vaginal prostaglandins are safe and efficacious options for women in the context of PROM at term.
足月胎膜早破（PROM）是一种常见情况，早期引产可降低感染发病率且不增加剖宫产率。缩宫素常用于引产，但前列腺素也常规使用。大型研究表明两种方法在母婴结局方面无差异。
评估与缩宫素相比，阴道前列腺素（PG）用于足月PROM引产的安全性和有效性。
这是在伊普斯威奇医院进行的一项单中心随机对照试验，纳入孕周≥37周且发生PROM的女性。根据当地指南对女性进行随机分组并在分娩时进行管理。分析采用意向性分析。
招募了184名女性，PG组90名，缩宫素组94名。两组女性人口统计学特征相似，PG组53%的女性不需要任何缩宫素。PG组胎儿心率异常发生率显著较低，分别为4.4%和12.8%。硬膜外使用、剖宫产、母体感染、入住特殊护理病房或新生儿败血症方面无差异。PG组分娩开始时间显著更长，分别为25.7小时和19.7小时，但第一产程长度无差异。两组产妇满意度均较高，母乳喂养率无显著差异。
对于足月PROM的女性，使用缩宫素或阴道前列腺素引产是安全有效的选择。
