Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, East Lake High-Tech Development Zone, Wuhan, China.
Ginekol Pol. 2021;92(12):662-664. doi: 10.5603/GP.a2021.0169.
Induction of labour is a beneficial perinatal procedure, but may be associated with some risks. The aim of this study was to identify factors associated with the need for Caesarean section in women referred for preinduction with dinoprostone and misoprostol.
It was a retrospective cohort study of 560 pregnant women who underwent labour induction for medical reasons. Analyses were performed separately in the dinoprostone and misoprostol group. Above other characteristics, the diameters of the pelvis and abdominal circumference of pregnant women were analysed.
There were some mothers' characteristics like age, weight, BMI, presence of hypothyroidism or diabetes, which were not associated with Caesarean section deliveries. Women in the misoprostol group with gestational age less than 38 weeks had an increased risk of Caesarean section (OR 2.189; p = 0.041). The analyses of combined effect of mothers age and parity history showed 6.7 (in dinoprostone group) and over 10 times (in misoprostol group) increased the risk of Caesarean section in nulliparous women over 35 years of age.
The increased risk of Caesarean delivery in the dinoprostone group was combined with the intertrochanteric dimensions such as the mother's height measuring less than 165 cm, nulliparity and hypertension. In the misoprostol group, strong risk factors for Caesarean delivery were mothers aged 35 years or more, gestational age less than 38 weeks and nulliparity and hypertension as in dinoprostone group. The oxytocin infusion had increased the risk of Caesarean section only in the combined dinoprostone and misoprostol group. Further high-quality studies are warranted.
引产是一种有益的围产期手术，但可能与一些风险相关。本研究旨在确定与因使用地诺前列酮和米索前列醇行引产而需行剖宫产相关的因素。
这是一项回顾性队列研究，共纳入 560 名因医学原因行引产的孕妇。对地诺前列酮组和米索前列醇组分别进行分析。除其他特征外，还分析了孕妇骨盆直径和腹围。
孕妇的一些特征，如年龄、体重、BMI、是否患有甲状腺功能减退或糖尿病，与剖宫产分娩无关。米索前列醇组中孕周小于 38 周的孕妇行剖宫产的风险增加（OR 2.189；p = 0.041）。分析母亲年龄和产次史的综合效应显示，在初产妇中，年龄超过 35 岁且无剖宫产史的孕妇发生剖宫产的风险增加 6.7 倍（地诺前列酮组），超过 10 倍（米索前列醇组）。
地诺前列酮组剖宫产风险增加与母亲身高低于 165cm、初产和高血压等转子间径有关。米索前列醇组剖宫产的强危险因素为年龄 35 岁或以上、孕周小于 38 周以及初产和高血压，与地诺前列酮组相似。催产素输注仅增加了地诺前列酮和米索前列醇联合用药组的剖宫产风险。需要进一步开展高质量的研究。
