Rabin Medical Center, Helen Schneider Hospital for Women, 39 Zabotinski St, 4941492, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arch Gynecol Obstet. 2019 Mar;299(3):765-771. doi: 10.1007/s00404-019-05080-5. Epub 2019 Feb 7.
To compare pregnancy outcomes following induction of labor with prostaglandins versus extra-amniotic balloon catheter indicated for term isolated oligohydramnios.
Retrospective cohort study of all women who underwent induction of labor due to term isolated oligohydramnios at a university affiliated medical center (2007-2016). The cohort was divided into two subgroups, according to induction method: vaginal prostaglandins E2 versus extra-amniotic balloon catheter. Primary outcomes were successful cervical ripening, defined as a Bishop score ≥ 8, and vaginal delivery rate. Secondary outcomes were neonatal adverse events.
Five hundred and ten women were included, of whom 454 (89%) underwent induction by prostaglandins and 56 (11%) by extra-amniotic balloon. Cervical ripening success rate was significantly higher in the prostaglandins group (89.4 vs. 76.79%, p = 0.006), as was the rate of vaginal delivery (77.53 vs. 48.21%, p < 0.0001). Induction with prostaglandins remained superior to extra-amniotic balloon in vaginal delivery rate following adjustment to potential confounders (aOR 3.470, 95% CI 1.296-9.296, p < 0.0001). Neonates delivered following induction with extra-amniotic balloon catheter were more often admitted to the neonatal intensive care unit (14.55 vs. 3.39%, p = 0.002).
Both prostaglandins and extra-amniotic balloon catheter are reasonable interventions for isolated term oligohydramnios. Prostaglandins were superior to extra-amniotic balloon both in cervical ripening success and in vaginal delivery rates.
比较前列腺素引产与特定位点羊水过少时应用羊膜外水囊导管引产的妊娠结局。
对某大学附属医院因足月特定位点羊水过少行引产的所有产妇（2007 年至 2016 年）进行回顾性队列研究。根据引产方法将队列分为两组：阴道前列腺素 E2 组和羊膜外水囊导管组。主要结局为宫颈成熟度成功，定义为 Bishop 评分≥8 分和阴道分娩率。次要结局为新生儿不良事件。
共纳入 510 例产妇，其中 454 例（89%）采用前列腺素引产，56 例（11%）采用羊膜外水囊导管引产。前列腺素组宫颈成熟成功率明显高于羊膜外水囊导管组（89.4%比 76.79%，p=0.006），阴道分娩率也更高（77.53%比 48.21%，p<0.0001）。调整潜在混杂因素后，前列腺素引产的阴道分娩率仍优于羊膜外水囊导管（调整后优势比 3.470，95%可信区间 1.296-9.296，p<0.0001）。使用羊膜外水囊导管引产的新生儿更常被收入新生儿重症监护病房（14.55%比 3.39%，p=0.002）。
前列腺素和羊膜外水囊导管均为特定位点足月羊水过少的合理干预措施。前列腺素在宫颈成熟成功率和阴道分娩率方面均优于羊膜外水囊导管。
