在临产前胎膜早破且宫颈条件不佳的孕妇中，使用阴道用普贝生在 6 小时内与在 6-24 小时内的应用比较。
Use of vaginal dinoprostone for women with term prelabor rupture of membranes and an unfavorable cervix within 6 h versus within 6-24 h.
机构信息
Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan, 430070, China.
出版信息
BMC Pregnancy Childbirth. 2024 Aug 20;24(1):548. doi: 10.1186/s12884-024-06760-0.
BACKGROUND
Most guidelines propose inducing labor within 24 h following term (37 or more weeks of gestation) prelabor rupture of membranes (PROM). However, the exact timing for initiating induction within the 24 h period remains unknown. This study aims to comparatively assess the efficacy and safety of the use of vaginal dinoprostone within 6 h versus within 6-24 h for singleton pregnancies with PROM and an unfavorable cervix (Bishop score < 6).
METHODS
This was a retrospective cohort study including singleton pregnancies with PROM and an unfavorable cervix (Bishop score < 6) in which labor was induced using vaginal dinoprostone. Women were divided into two groups according to the timing of the use of induction (within 6 h versus within 6-24 h after PROM). Baseline maternal data, maternal and neonatal outcomes were recorded for statistical analysis.
RESULTS
450 women were included, 146 (32.4%) of whom were induced within 6 h of PROM and 304 (67.6%) were induced within 6-24 h. Cesarean delivery rate (15.8% versus 29.3%, p = 0.002) and nonreassuring fetal heart rate tracing (4.8% versus 10.5%, p = 0.043) in group with vaginal dinoprostone within 6 h were significantly lower than those in group with vaginal dinoprostone within 6-24 h. There was no significant differences in terms of duration from IOL to vaginal delivery.
CONCLUSION
Induction of labor within 6 h with vaginal dinoprostone after PROM for singleton pregnancies with an unfavorable cervix (Bishop score < 6) significantly associated with less cesarean section, less nonreassuring fetal heart rate tracing, compared to induction of labor within 6-24 h after PROM.
背景
大多数指南建议在足月（妊娠 37 周或以上）胎膜早破（PROM）后 24 小时内引产。然而，在 24 小时内启动引产的确切时间仍不清楚。本研究旨在比较评估在宫颈条件不佳（Bishop 评分<6）的单胎妊娠 PROM 孕妇中，在 6 小时内与 6-24 小时内使用阴道普贝生引产的疗效和安全性。
方法
这是一项回顾性队列研究，纳入了宫颈条件不佳（Bishop 评分<6）的单胎妊娠 PROM 孕妇，使用阴道普贝生引产。根据引产时机（PROM 后 6 小时内与 6-24 小时内）将孕妇分为两组。记录基线产妇数据、母婴结局进行统计学分析。
结果
共纳入 450 例孕妇，其中 146 例（32.4%）在 PROM 后 6 小时内引产，304 例（67.6%）在 6-24 小时内引产。6 小时内使用阴道普贝生引产组的剖宫产率（15.8% vs. 29.3%，p=0.002）和非典型胎心监护率（4.8% vs. 10.5%，p=0.043）显著低于 6-24 小时内使用阴道普贝生引产组。两组从宫口扩张至阴道分娩的时间无显著差异。
结论
对于宫颈条件不佳（Bishop 评分<6）的单胎妊娠 PROM 孕妇，在 PROM 后 6 小时内使用阴道普贝生引产与在 PROM 后 6-24 小时内引产相比，显著降低了剖宫产率和非典型胎心监护率。
Zotero 插件