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比较地诺前列酮阴道栓剂与双球囊导管在中国患者中作为宫颈成熟治疗方法的有效性和安全性。

Comparing the effectiveness and safety of Dinoprostone vaginal insert and double-balloon catheter as cervical ripening treatments in Chinese patients.

作者信息

Yan Jinjing, Yin Baomin, Lv Hanghang

机构信息

Department of Obstetrics, Zhuhai Center for Maternal and Child Health Care (Zhuhai Maternal and Child Health Hospital), Zhuhai, Guangdong, China.

出版信息

Front Med (Lausanne). 2022 Sep 9;9:976983. doi: 10.3389/fmed.2022.976983. eCollection 2022.

Abstract

BACKGROUND

This retrospective study was to compare the effectiveness and safety of Dinoprostone vaginal insert vs. double-balloon catheter as cervical ripening agents for labor induction.

METHODS

Pregnant women with Bishop score <7, who received either Dinoprostone vaginal insert 10 mg or Cook's double-balloon catheter for labor induction, were studied. The primary outcome was the rate of vaginal delivery within 48 h; the secondary outcomes were the proportion of women undergoing cesarean section, labor duration, oxytocin administration, changes in Bishop score, complications during labor, and maternal/neonatal outcomes.

RESULTS

One hundred and eighty-two women were included in Dinoprostone group, and 199 women were in double-balloon catheter group. The rate of vaginal delivery within 48 h was significantly higher in Dinoprostone group than that in double-balloon catheter group (90.11% vs. 75.38%, = 0.0002). There were 18 cesarean section deliveries (9.89%) in Dinoprostone group and 49 cesarean section deliveries (24.62%) in double-balloon catheter group, with significant differences between two groups ( = 0.0002). The duration of labor was higher in Dinoprostone group, while the augmentation with oxytocin was significantly lower in Dinoprostone group than in double-balloon catheter group (all < 0.0001). The incidence of chorioamnionitis was significantly higher in double-balloon catheter group as compared with Dinoprostone group (0 vs. 12, = 0.0005), while neonatal outcomes were similar in two groups.

CONCLUSION

Dinoprostone vaginal insert as cervical ripening agent is more effective for labor induction and with lower risks of chorioamnionitis as compared with double balloon catheter in Chinese populations.

摘要

背景

本回顾性研究旨在比较地诺前列酮阴道栓剂与双球囊导管作为引产促宫颈成熟剂的有效性和安全性。

方法

对 Bishop 评分<7 且接受 10mg 地诺前列酮阴道栓剂或库克双球囊导管引产的孕妇进行研究。主要结局为 48 小时内阴道分娩率;次要结局包括剖宫产妇女比例、产程、缩宫素使用情况、Bishop 评分变化、分娩期间并发症以及母婴结局。

结果

地诺前列酮组纳入 182 名妇女,双球囊导管组纳入 199 名妇女。地诺前列酮组 48 小时内阴道分娩率显著高于双球囊导管组(90.11%对 75.38%,P = 0.0002)。地诺前列酮组有 18 例剖宫产分娩(9.89%),双球囊导管组有 49 例剖宫产分娩(24.62%),两组间差异有统计学意义(P = 0.0002)。地诺前列酮组产程较长,而地诺前列酮组缩宫素增用率显著低于双球囊导管组(均 P < 0.0001)。双球囊导管组绒毛膜羊膜炎发生率显著高于地诺前列酮组(0 对 12,P = 0.0005),而两组新生儿结局相似。

结论

在中国人群中,地诺前列酮阴道栓剂作为促宫颈成熟剂用于引产比双球囊导管更有效,且绒毛膜羊膜炎风险更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e72a/9500470/182f29110735/fmed-09-976983-g0001.jpg

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