Department of Obstetrics & Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Obstetrics & Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA.
Best Pract Res Clin Obstet Gynaecol. 2021 Nov;77:53-63. doi: 10.1016/j.bpobgyn.2021.09.003. Epub 2021 Sep 15.
Oral and vaginal misoprostol are effective induction methods, but there is a delicate balance between a quicker labour and avoiding side effects. In randomised comparisons with balloon catheters, oral misoprostol resulted in more vaginal births in the first 24 h as well as fewer caesarean sections without an increase in hyperstimulation events. Vaginal misoprostol was most effective when used concurrently with a balloon catheter. In comparison with dinoprostone, oral misoprostol had lower rates of caesarean section and uterine hyperstimulation with foetal heart rate changes, but fewer babies were born vaginally within 24 h. In contrast, vaginal misoprostol resulted in more vaginal births within 24 h, with no significant differences in caesarean section rates. There were no differences in perinatal adverse events with either route. When oral and vaginal misoprostol were compared, vaginal misoprostol resulted in more vaginal births in the first 24 h, but with more maternal and neonatal complications.
口服和阴道米索前列醇都是有效的引产方法，但在更快的分娩和避免副作用之间存在微妙的平衡。与球囊导管的随机对照比较显示，口服米索前列醇在 24 小时内阴道分娩的比例更高，剖宫产的比例更低，而没有增加过度刺激事件。当与球囊导管同时使用时，阴道米索前列醇最有效。与地诺前列酮相比，口服米索前列醇剖宫产率和子宫过度刺激胎儿心率变化的发生率较低，但 24 小时内阴道分娩的婴儿较少。相比之下，阴道米索前列醇在 24 小时内阴道分娩的比例更高，剖宫产率无显著差异。两种途径的围产期不良事件无差异。当比较口服和阴道米索前列醇时，阴道米索前列醇在头 24 小时内阴道分娩的比例更高，但产妇和新生儿并发症更多。
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