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一项关于足月引产时宫颈成熟方法的有效性、安全性、女性体验和 3 个月时生活质量的前瞻性观察研究——MATUCOL 研究方案。

Prospective observational study investigating the effectiveness, safety, women's experiences and quality of life at 3 months regarding cervical ripening methods for induction of labor at term-The MATUCOL study protocol.

机构信息

Department of Obstetrics and Gynecology, Centre Hospitalier Departemental, 85000, La Roche sur Yon, France.

Clinical Research Center, Centre Hospitalier Departemental, 85000, La Roche sur Yon, France.

出版信息

PLoS One. 2022 Jan 21;17(1):e0262292. doi: 10.1371/journal.pone.0262292. eCollection 2022.

Abstract

BACKGROUND

The purposes of successful induction of labor (IOL) are to shorten the time for IOL to delivery, increase the vaginal delivery rate, and reduce the rate of maternal and neonatal morbidity. In cases of unfavorable cervix (Bishop score <6), cervical ripening is advised to improve vaginal delivery rate. It may be initiated by mechanical (double balloon catheter (DBC), synthetic osmotic dilator) or pharmacologic (prostaglandins) methods, and the problem is complex due to the multitude of cervical ripening methods. We are constantly looking for the optimal protocol of cervical ripening for each woman. The present study aims to elucidate whether cervical ripening method is associated with increase rate of vaginal delivery, good women's experience and unaltered long-term quality of life after cervical ripening at term regarding maternal and obstetric characteristics.

METHODS AND DESIGN

The MATUCOL study is a monocentric, prospective, observational study of all consecutive women who required cervical ripening (Bishop score <6) using different methods (DBC, vaginal dinoprostone, oral misoprostol) with a live fetus at term (≥37 weeks) between January 2020 and August 2021. The outcomes will be mode of delivery, maternal and neonatal morbidity, discomfort/pain assessments during cervical ripening, women's experience and satisfaction, and the impact of cervical ripening on the health-related quality of life at 3 months. If it reports a significant efficacy/safety/perinatal morbidity/women's satisfaction/quality of life at 3 months post-delivery associated with a method of cervical ripening in a specific situation (gestational and/or fetal disease) using a multivariate analysis, its use should be reconsidered in clinical practice.

DISCUSSION

This study will reveal that some cervical ripening methods will be more effectiveness, safe, with good women's experiences and QOL at 3 months compared to others regarding maternal and obstetric characteristics.

TRIAL REGISTRATION

This study is being performed at La Roche sur Yon Hospital following registration as GNEDS on January 8, 2020.

摘要

背景

成功引产(IOL)的目的是缩短 IOL 分娩时间,提高阴道分娩率,降低母婴发病率。在宫颈条件不佳(Bishop 评分<6)的情况下,建议进行宫颈成熟以提高阴道分娩率。可以通过机械(双球囊导管(DBC)、合成渗透扩张器)或药物(前列腺素)方法来启动,由于宫颈成熟方法众多,问题比较复杂。我们一直在为每位女性寻找最佳的宫颈成熟方案。本研究旨在阐明在足月时,根据产妇和产科特征,宫颈成熟方法是否与阴道分娩率的增加、产妇的良好体验以及宫颈成熟后长期生活质量的改变有关。

方法和设计

MATUCOL 研究是一项单中心、前瞻性、观察性研究,纳入了 2020 年 1 月至 2021 年 8 月期间所有因宫颈条件不佳(Bishop 评分<6)而需要宫颈成熟(DBC、阴道dinoprostone、口服米索前列醇)的连续足月(≥37 周)活胎产妇。结局指标为分娩方式、母婴发病率、宫颈成熟过程中的不适/疼痛评估、产妇体验和满意度,以及宫颈成熟对产后 3 个月健康相关生活质量的影响。如果在多变量分析中发现某种宫颈成熟方法与特定情况下(妊娠和/或胎儿疾病)的某种方法相关,具有显著的疗效/安全性/围产期发病率/产妇满意度/生活质量,那么该方法在临床实践中应重新考虑。

讨论

本研究将揭示在产妇和产科特征方面,与其他方法相比,某些宫颈成熟方法在有效性、安全性、产妇体验和产后 3 个月生活质量方面更有优势。

试验注册

本研究在 La Roche sur Yon 医院进行,于 2020 年 1 月 8 日在 GNEDS 注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b4b/8782477/9fe8264be976/pone.0262292.g001.jpg

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