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口服米索前列醇引产:妊娠34周以上患者不同剂量方案对母婴结局的比较

Oral Misoprostol for the Induction of Labor: Comparison of Different Dosage Schemes With Respect to Maternal and Fetal Outcome in Patients Beyond 34 Weeks of Pregnancy.

作者信息

Ratiu Oana, Ratiu Dominik, Mallmann Peter, DI Liberto Alexander, Ertan A Kubilay, Morgenstern Bernd, Mallmann Michael R, Ludwig Sebastian, Grüttner Berthold, Eichler Christian, Thangarajah Fabinshy, Gilman Elena, Abel Judith S

机构信息

Department of Gynecology and Obstetrics, Leverkusen Municipal Hospital, Leverkusen, Germany.

Department of Obstetrics and Gynecology, University Hospital Cologne and Medical Faculty, Cologne, Germany.

出版信息

In Vivo. 2022 May-Jun;36(3):1285-1289. doi: 10.21873/invivo.12828.

Abstract

BACKGROUND/AIM: Labor is induced in 1 out of 5 pregnancies. This is why we aimed to compare two different protocols of orally administered misoprostol for the induction of labor (IOL), with special regard to maternal and fetal outcome, delivery mode and duration.

PATIENTS AND METHODS

One hundred and twenty four patients with a medical indication for IOL were divided into two groups: Group A (n=63), which initially received 50 μg misoprostol escalated to 100 and, subsequently, to 200 μg every 4 h with a daily maximum of 600μg, between 11/2007 and 01/2008; and Group B (n=61), which initially received 25 μg misoprostol followed by 100 μg every 4 h with a daily maximum of 300 μg, between 12/2009 and 04/2010.

RESULTS

The mean administration-delivery interval was significantly lower in Group A (19.0 h) compared to Group B (27.1 h, p<0.05). Overall caesarean section rate, average birth weight, APGAR score, umbilical cord pH and meconium-stained fluid rates were similar between both groups.

CONCLUSION

A higher dosage protocol of orally administered misoprostol significantly reduces the mean induction-delivery interval without increasing the risk for an adverse maternal or fetal outcome.

摘要

背景/目的:五分之一的妊娠会进行引产。这就是我们旨在比较两种不同的口服米索前列醇引产方案的原因,特别关注母婴结局、分娩方式和产程。

患者与方法

124例有引产医学指征的患者被分为两组:A组(n = 63),在2007年11月至2008年1月期间,最初接受50μg米索前列醇,每4小时递增至100μg,随后递增至200μg,每日最大剂量为600μg;B组(n = 61),在2009年12月至2010年4月期间,最初接受25μg米索前列醇,随后每4小时接受100μg,每日最大剂量为300μg。

结果

A组的平均给药至分娩间隔(19.0小时)显著低于B组(27.1小时,p<0.05)。两组的总体剖宫产率、平均出生体重、阿氏评分、脐血pH值和羊水胎粪污染率相似。

结论

口服米索前列醇的高剂量方案可显著缩短平均引产至分娩间隔,且不会增加母婴不良结局的风险。

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Misoprostol for induction of labour: a systematic review.米索前列醇用于引产:一项系统评价。
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Induction of labor with misoprostol in pregnancies with advanced maternal age.米索前列醇用于高龄孕妇引产。
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本文引用的文献

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Oral misoprostol for induction of labour.口服米索前列醇引产。
Cochrane Database Syst Rev. 2014 Jun 13;2014(6):CD001338. doi: 10.1002/14651858.CD001338.pub3.
9
ACOG Practice Bulletin No. 107: Induction of labor.美国妇产科医师学会实践公告第107号:引产
Obstet Gynecol. 2009 Aug;114(2 Pt 1):386-397. doi: 10.1097/AOG.0b013e3181b48ef5.

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