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预测宫内生长受限妊娠中使用慢释型地诺前列酮促宫颈成熟的成功率的变量。

Predictor variables in the success of slow-release dinoprostone used for cervical ripening in intrauterine growth restriction pregnancies.

机构信息

Department of Obstetrics and Gynecology, University of Health Sciences, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

Department of Obstetrics and Gynecology, University of Health Sciences, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

出版信息

J Gynecol Obstet Hum Reprod. 2020 Jun;49(6):101739. doi: 10.1016/j.jogoh.2020.101739. Epub 2020 Apr 3.

Abstract

OBJECTIVE

This study aims to evaluate the consequences of a trigger by vaginal Dinoprotone on outcome of pregnancies with Intrauterine growth restriction (IUGR).

MATERIALS AND METHODS

This retrospective study included 161 induced IUGR fetuses (35-39 weeks). Consecutive patients who were evaluated formed the basis of the clinical outcomes. The penalized maximum likelihood estimation (PMLE) method was used instead of traditional logistic regression in order to reduce the risk of overfitting.

RESULTS

Of the 25,678 deliveries that occurred during the study period, 161 (0.6%) women underwent IUGR delivery; of these, 117 (73%) succeeded and 44 (27%) failed to achieve cervical ripening using the dinoprostone slow-release vaginal insert. Two predictors were associated with dinoprostone vaginal delivery success: Parity (OR:1.4([0.89-2.3]), and Bishop score (OR:1.54[1.23-1.94]). The PMLE model correctly classified 78% participants (c-index: 0.78).

CONCLUSION

Basic parameters such as parity and Bishop score can be used to predict successful vaginal birth following dinoprostone slow-release vaginal insert administration.

摘要

目的

本研究旨在评估阴道用 Dinoprotone 触发对宫内生长受限(IUGR)妊娠结局的影响。

材料和方法

本回顾性研究纳入了 161 例引产的 IUGR 胎儿(35-39 周)。连续评估的患者构成了临床结局的基础。为了降低过度拟合的风险,采用惩罚最大似然估计(PMLE)方法代替传统的逻辑回归。

结果

在研究期间,25678 例分娩中,有 161 例(0.6%)妇女进行了 IUGR 分娩;其中 117 例(73%)成功,44 例(27%)未能使用地诺前列酮阴道缓释栓达到宫颈成熟。有两个预测因素与地诺前列酮阴道分娩成功相关:产次(OR:1.4[0.89-2.3])和 Bishop 评分(OR:1.54[1.23-1.94])。PMLE 模型正确分类了 78%的参与者(c 指数:0.78)。

结论

基本参数如产次和 Bishop 评分可用于预测地诺前列酮阴道缓释栓给药后阴道分娩的成功率。

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