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前列腺素E1和E2引产的结果(成熟度引产研究):阴道栓剂药物引产的产科有效性和临床结局的真实世界数据分析

Results of Induction of Labor with Prostaglandins E1 and E2 (The RIPE Study): A Real-World Data Analysis of Obstetrical Effectiveness and Clinical Outcomes of Pharmacological Induction of Labor with Vaginal Inserts.

作者信息

Socha Maciej W, Flis Wojciech, Pietrus Miłosz, Wartęga Mateusz

机构信息

Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza 1, 85-821 Bydgoszcz, Poland.

Department of Obstetrics and Gynecology, St. Adalbert's Hospital in Gdańsk, Copernicus Healthcare Entity, Jana Pawła II 50, 80-462 Gdańsk, Poland.

出版信息

Pharmaceuticals (Basel). 2023 Jul 8;16(7):982. doi: 10.3390/ph16070982.

Abstract

Despite extensive knowledge of the mechanisms responsible for childbirth, the course of labor induction is often unpredictable. Therefore, labor induction protocols using prostaglandin analogs have been developed and tested to assess their effectiveness in labor induction unequivocally. A total of 402 women were collected into two groups-receiving vaginal Misoprostol or vaginal Dinoprostone for induction of labor (IOL). Then, the patients were compared in groups depending on the agent they received and their gestational age. Most patients delivered within 48 h, and most of these patients had vaginal parturition. Patients who received the Dinoprostone vaginal insert required statistically significantly more oxytocin administration than patients who received the Misoprostol vaginal insert. Patients who received the Misoprostol vaginal insert used anesthesia during labor statistically more often. Patients who received Misoprostol vaginal inserts had a statistically significantly shorter time to delivery than those with Dinoprostone vaginal inserts. The prevalence of hyperstimulation was similar in all groups and remained low. Vaginal Misoprostol-based IOL is characterized by a shortened time to delivery irrespective of the parturition type, and a lower need for oxytocin augmentation, but also by an increased demand for intrapartum analgesia administration. A vaginal Dinoprostone-based IOL protocol might be considered a more harmonious and desirable option in modern perinatal care.

摘要

尽管对分娩机制有广泛了解,但引产过程往往难以预测。因此,已开发并测试了使用前列腺素类似物的引产方案,以明确评估其引产效果。共有402名妇女被分为两组,分别接受阴道米索前列醇或阴道地诺前列酮引产。然后,根据患者所接受的药物及其孕周对两组患者进行比较。大多数患者在48小时内分娩,其中大多数患者为阴道分娩。接受阴道地诺前列酮栓剂的患者比接受阴道米索前列醇栓剂的患者在统计学上需要更多的缩宫素给药。接受阴道米索前列醇栓剂的患者在分娩期间使用麻醉的比例在统计学上更高。接受阴道米索前列醇栓剂的患者分娩时间在统计学上显著短于接受阴道地诺前列酮栓剂的患者。所有组中子宫过度刺激的发生率相似且较低。基于阴道米索前列醇的引产具有分娩时间缩短(与分娩类型无关)、缩宫素加强需求较低的特点,但也存在产时镇痛给药需求增加的情况。基于阴道地诺前列酮的引产方案在现代围产期护理中可能被认为是更和谐、更理想的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a91/10384291/47fd35fc0f64/pharmaceuticals-16-00982-g001.jpg

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