Gornisiewicz Teresa, Huras Hubert, Kusmierska-Urban Katarzyna, Galas Aleksander
Department of Obstetrics and Perinatology, University Hospital, Cracow, Poland.
Department of Obstetrics and Perinatology, Jagiellonian University Medical College, Cracow, Poland.
Ginekol Pol. 2021 Jun 9. doi: 10.5603/GP.a2021.0092.
The aim of the study was to evaluate whether the presence of the disease in pregnancy influences the effectiveness and safety of delivery preinduction with prostaglandins: misoprostol vaginal insert and dinoprostone vaginal gel.
This is aretrospective cohort study conducted of 560 pregnant women. The concomitant diseases mainly recorded were diabetes mellitus, hypertensive diseases, intrahepatic cholestasis of pregnancy, asthma, thrombocytopenia, and hypothyroidism. The primary study outcome was a successful vaginal delivery. The study above others evaluates the time from treatment implementation to the beginning of a labor and to a final delivery, the rate of Cesarean sections, and the presence of delivery complications.
Among women with a concomitant disease, Caesarean section was observed more frequently in the misoprostol group. In the dinoprostone group, mothers with the concomitant disease as compared to healthy mothers required more time to the delivery and to achieve the beginning of labor. There were no differences in postpartum complications regardless of the prostaglandins, comorbidities or mothers' age. Neonates of mothers ≥ 35 years old with concomitant disease had lower average Apgar scores.
Our study showed that comorbidities seem to increase the caesarean section risk in the misoprostol preinduction group but in the dinoprostone group they prolong the time needed to achieve an active labour phase and a delivery.
本研究旨在评估孕期疾病的存在是否会影响使用前列腺素进行引产的有效性和安全性：米索前列醇阴道栓剂和地诺前列酮阴道凝胶。
这是一项对560名孕妇进行的回顾性队列研究。主要记录的合并疾病有糖尿病、高血压疾病、妊娠期肝内胆汁淤积症、哮喘、血小板减少症和甲状腺功能减退症。主要研究结局是成功的阴道分娩。该研究还评估了从治疗开始到分娩开始以及最终分娩的时间、剖宫产率和分娩并发症的发生情况。
在患有合并疾病的女性中，米索前列醇组剖宫产的发生率更高。在地诺前列酮组中，患有合并疾病的母亲与健康母亲相比，分娩和开始分娩所需的时间更长。无论使用何种前列腺素、合并症或母亲年龄如何，产后并发症均无差异。≥35岁患有合并疾病的母亲所生新生儿的平均阿氏评分较低。
我们的研究表明，合并症似乎会增加米索前列醇引产组的剖宫产风险，但在地诺前列酮组中，合并症会延长进入活跃分娩期和分娩所需的时间。
