Ting Ning-Shiuan, Wei Yu-Chi, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan.
Medicina (Kaunas). 2025 Jul 10;61(7):1255. doi: 10.3390/medicina61071255.
For many patients, the induction-to-delivery interval is shorter with Propess than with Prostin E2. However, some patients also require Prostin E2 to sufficiently boost their dinoprostone levels to achieve cervical change and vaginal delivery. In this study, we compared the efficacy of different timings of Prostin E2 administration after Propess use. This single-institution retrospective cohort study was conducted between January 2020 and August 2023. The inclusion criterion was an unfavorable cervix (Bishop score ≤ 6) after Propess use for 8 h. We divided the patients into three groups based on the addition of Prostin E2 at the 8th (group 1), 12th (group 2), and 24th (group 3) hour after Propess insertion. The primary outcome was the cesarean section rate. The secondary outcomes were the induction-to-birth interval, Bishop score at 24 h, neonatal outcomes, and the predictors of labor induction duration. A total of 63 patients were analyzed across three groups based on the timing of Prostin E2 administration (8, 12, and 24 h). The gestational age differed significantly between groups ( < 0.001), with the highest age being observed in the 24 h group. The 8 h group had the shortest induction-to-birth interval ( < 0.001) and the highest Bishop scores after 24 h of Propess use ( < 0.001). Blood loss was lowest in the 12 h group ( = 0.027). No significant differences were found in relation to the mode of birth, tachysystole, neonatal birth weight, or Apgar scores. A multivariable analysis identified gestational age (β = 3.33; = 0.015) and Bishop score after 24 h of PGE2 (β = -1.99; < 0.001) as being independent predictors of labor duration. administering Prostin E2 to patients who had a poor response after Propess use was safe; additionally, adding it at the 8th hour after Propess initiation could result in a shorter induction-to-birth interval.
对于许多患者而言，使用普贝生（Propess）后的引产至分娩间隔比使用卡前列甲酯栓（Prostin E2）更短。然而，一些患者也需要使用卡前列甲酯栓来充分提高其地诺前列酮水平，以实现宫颈变化和经阴道分娩。在本研究中，我们比较了在使用普贝生后不同时间给予卡前列甲酯栓的疗效。这项单机构回顾性队列研究于2020年1月至2023年8月进行。纳入标准为使用普贝生8小时后宫颈条件不佳（Bishop评分≤6分）。我们根据在放置普贝生后的第8小时（第1组）、第12小时（第2组）和第24小时（第3组）添加卡前列甲酯栓，将患者分为三组。主要结局是剖宫产率。次要结局包括引产至分娩间隔、24小时时的Bishop评分、新生儿结局以及引产持续时间的预测因素。根据卡前列甲酯栓给药时间（8小时、12小时和24小时）对三组共63例患者进行了分析。各组之间的孕周差异显著（<0.001），24小时组的孕周最高。8小时组的引产至分娩间隔最短（<0.001），且在使用普贝生24小时后的Bishop评分最高（<0.001）。12小时组的失血量最低（=0.027）。在分娩方式、子宫收缩过速、新生儿出生体重或阿氏评分方面未发现显著差异。多变量分析确定孕周（β = 3.33；= 0.015）和使用PGE2 24小时后的Bishop评分（β = -1.99；<0.001）是产程的独立预测因素。对使用普贝生后反应不佳的患者给予卡前列甲酯栓是安全的；此外，在放置普贝生后的第8小时添加可导致更短的引产至分娩间隔。
