Zheng Rui, Du Lijia, Zhu Xiaoxiong, Zhang Xiaoying, Han Weihua, Yang Zhifen
Department of Obstetrics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Obstetrics, Handan Central Hospital, Handan, China.
BMC Pregnancy Childbirth. 2025 Mar 15;25(1):295. doi: 10.1186/s12884-025-07375-9.
To compare the induction-to-delivery time and maternal satisfaction associated with vaginal misoprostol combined with a Foley balloon to those associated with vaginal misoprostol alone for labor induction.
This was a prospective cohort study involving singleton full-term pregnant women with fetuses who were observed in the cephalic position; these patients were divided into a combination group (25 µg vaginal misoprostol combined with a Foley balloon, n = 94) and a misoprostol group (25 µg vaginal misoprostol, n = 105). The primary outcome was the induction-to-delivery time, and the secondary outcomes included maternal satisfaction, mode of delivery and neonatal conditions.
The induction-to-delivery time was significantly lower in the combination group than in the misoprostol group (13.91 [10.85-21.48] hours vs. 17.8 [12.63-26.63] hours, respectively; P = 0.016), and this difference was still observed in analyses including only those women with vaginal births (13.40 [10.65-20.47] hours vs. 18.49 [12.91-27.00] hours, respectively; P = 0.001). Stratified analysis revealed that this benefit was particularly significant among nulliparous women. The questionnaire survey revealed similar levels of maternal satisfaction with birth experience between the combination group and the misoprostol group (69.9% vs. 66.7%, P = 0.627) but a higher rate of pain during labor induction in the combination group (16% vs. 5.8%, P = 0.02). No significant differences were observed in neonatal conditions, satisfaction rates regarding the duration of labor induction and the frequency and intensity of contractions between the groups.
Vaginal misoprostol combined with a Foley balloon effectively shortens the induction-to-delivery time but induces more severe pain during labor induction, thus providing overall satisfaction comparable to that of vaginal misoprostol for labor induction. An optimal scheme for labor induction should be determined according to expectations regarding the induction-to-delivery time, and the personal feelings of the pregnant women.
比较阴道米索前列醇联合Foley球囊与单纯阴道米索前列醇用于引产时的引产至分娩时间及产妇满意度。
这是一项前瞻性队列研究，纳入单胎足月孕妇，胎儿为头位；这些患者被分为联合组（25μg阴道米索前列醇联合Foley球囊，n = 94）和米索前列醇组（25μg阴道米索前列醇，n = 105）。主要结局是引产至分娩时间，次要结局包括产妇满意度、分娩方式和新生儿情况。
联合组的引产至分娩时间显著低于米索前列醇组（分别为13.91[10.85 - 21.48]小时和17.8[12.63 - 26.63]小时；P = 0.016），在仅包括经阴道分娩女性的分析中仍观察到这种差异（分别为13.40[10.65 - 20.47]小时和18.49[12.91 - 27.00]小时；P = 0.001）。分层分析显示，这种益处在初产妇中尤为显著。问卷调查显示，联合组和米索前列醇组产妇对分娩经历的满意度水平相似（69.9%对66.7%，P = 0.627），但联合组引产时疼痛发生率较高（16%对5.8%，P = 0.02）。两组在新生儿情况、引产持续时间满意度以及宫缩频率和强度方面未观察到显著差异。
阴道米索前列醇联合Foley球囊可有效缩短引产至分娩时间，但引产时会引起更严重的疼痛，因此在引产总体满意度方面与单纯阴道米索前列醇相当。应根据对引产至分娩时间的期望以及孕妇的个人感受来确定最佳引产方案。
