Sulkowski Camille, Schneider Floriane, Tessier Vincent, Toullalan Olivier, Grouin Amélie
Centre Hospitalier Universitaire de Nice, Hôpital l'Archet II, Maternité niveau III, France.
Centre Hospitalier de Cannes Simone Veil, Maternité niveau IIA, France.
J Gynecol Obstet Hum Reprod. 2019 Oct;48(8):669-672. doi: 10.1016/j.jogoh.2019.05.004. Epub 2019 May 7.
To compare the efficiency of double balloon catheters with that of intravaginal prostaglandins alone for the labor induction of unfavourable cervices in term nulliparous women.
50 nulliparous patients induced with a double balloon device were compared to 53 patients induced using intravaginal prostaglandins alone. The main outcome measure was labour induction failure, characterized by the absence of active labour. The secondary outcome measures were the improvement of the Bishop score, the average durations of ripening and labour induction, the average time to active labour, the need for a second cervical ripening agent, the total dose of prostaglandins used in each group, the use of oxytocins, as well as the rates of vaginal delivery, abnormal foetal heart rate during labour and perinatal maternal infection.
The rate of failed labour induction was of 28% in the double balloon group, against 13% in the prostaglandins group. The average durations of ripening and labour induction, as well as the time to active labour were higher in the double balloon group. The improvement of the Bishop score was significantly lower in the double balloon group.
In our study, the use of double balloon catheters does not seem to reduce the rate of failed labour induction in nulliparous women when compared to the use of prostaglandins alone. In addition, it could lengthen the labour induction duration, although more powerful studies would be necessary not to recommend its use for nulliparous women.
比较双球囊导管与单纯阴道内使用前列腺素在足月未产妇宫颈条件不佳时引产的效率。
将50例使用双球囊装置引产的未产妇与53例单纯使用阴道内前列腺素引产的患者进行比较。主要结局指标是引产失败，其特征为无活跃产程。次要结局指标包括 Bishop 评分的改善情况、促宫颈成熟和引产的平均持续时间、至活跃产程的平均时间、是否需要使用第二种促宫颈成熟药物、每组使用的前列腺素总剂量、缩宫素的使用情况，以及阴道分娩率、产程中异常胎心率和围产期母体感染率。
双球囊组引产失败率为28%，前列腺素组为13%。双球囊组促宫颈成熟和引产的平均持续时间以及至活跃产程的时间更长。双球囊组 Bishop 评分的改善明显更低。
在我们的研究中，与单纯使用前列腺素相比，使用双球囊导管似乎并未降低未产妇引产失败率。此外，它可能会延长引产持续时间，尽管需要更有力的研究才能不推荐未产妇使用。
