Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
J Obstet Gynaecol. 2022 Oct;42(7):2693-2697. doi: 10.1080/01443615.2022.2084370. Epub 2022 Jul 2.
The purpose of this trial was to compare extra-amniotic saline infusion (EASI) and intravaginal isoniazid (INH) for cervical ripening. This randomised clinical trial included 150 pregnant women who were undergoing induction of labour and who required pre-induction cervical ripening. Patients were randomly assigned to receive EASI or intravaginal INH. Bishop's score at the beginning of the study and before oxytocin infusion was not significantly different between INH and EASI groups. However, the time from first intervention to the beginning of the induction and also to the beginning of the active phase were significantly shorter in EASI group ( value ≤.001). Moreover, INH did not influence the labour process after the beginning of the active phase of labour. In conclusion, INH could be used for cervical ripening especially in the outpatient setting; however, it is a slower ripening agent compared to EASI.Impact Statement To date there has been only one study about the safety and effectiveness of isoniazid (INH) in cervical ripening at term pregnancy which has compared INH with misoprostol. The results of this study showed that vaginal INH is an effective agent for cervical ripening at term but in comparison to extra-amniotic saline infusion (EASI) it takes a longer time. INH can be used in outpatient settings for cervical ripening at term pregnancy which makes it convenient for patient and cost effective for both patient and health system. Further studies are needed to discover the clinical efficacy of INH in comparison to other ripening methods and also the best dosage of INH for cervical ripening.
本试验旨在比较宫腔外盐水输注（EASI）和阴道异烟肼（INH）在宫颈成熟中的作用。这项随机临床试验纳入了 150 名接受引产且需要引产前宫颈成熟的孕妇。患者被随机分为 EASI 组或阴道 INH 组。研究开始时和催产素输注前，Bishop 评分在 INH 组和 EASI 组之间无显著差异。然而，EASI 组从首次干预到引产开始以及到活跃期开始的时间明显缩短（P 值≤0.001）。此外，INH 不影响活跃期开始后的分娩过程。总之，INH 可用于宫颈成熟，尤其是在门诊环境下；然而，与 EASI 相比，它是一种成熟速度较慢的药物。
目前，关于 INH 在足月妊娠中用于宫颈成熟的安全性和有效性，仅有一项研究将 INH 与米索前列醇进行了比较。本研究结果表明，阴道 INH 是足月妊娠宫颈成熟的有效药物，但与宫腔外盐水输注（EASI）相比，它需要更长的时间。INH 可用于门诊足月妊娠宫颈成熟，方便患者，对患者和医疗体系均具有成本效益。需要进一步研究以发现 INH 与其他成熟方法相比的临床疗效，以及 INH 用于宫颈成熟的最佳剂量。
