Stone J L, Lockwood C J, Berkowitz G, Alvarez M, Lapinski R, Valcamonico A, Berkowitz R L
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
Am J Perinatol. 1994 Jul;11(4):309-12. doi: 10.1055/s-2007-994600.
The aim of this study was to determine whether preinduction cervical ripening with prostaglandin E2 (PgE2) gel in patients with one previous cesarean section may be used with the same safety and efficacy as in patients without a uterine scar. Primiparous patients (n = 94) with one previous cesarean section were retrospectively compared to nulliparous patients (n = 866). Both groups underwent preinduction cervical ripening with 2 mg intracervical PgE2 gel. Logistic regression was performed to control for confounding factors. Our statistical power was 90% for detecting a doubling of the complication rate, from 10 to 20%. There were no significant differences in the duration of ruptured membranes or length of labor between the two groups. No significant differences were detected in the rate or indications for cesarean section, presence of thick meconium, epidural anesthesia use, amnionitis, or maternal and neonatal morbidity. There were no cases of uterine rupture in either group. PgE2 gel may be used with the same safety and efficacy in patients with previous cesarean section as in nulliparas.
本研究的目的是确定，对于有过一次剖宫产史的患者，术前使用前列腺素E2（PgE2）凝胶进行宫颈成熟处理，其安全性和有效性是否与无子宫瘢痕的患者相同。将有过一次剖宫产史的初产妇（n = 94）与未产妇（n = 866）进行回顾性比较。两组均采用2mg宫颈内PgE2凝胶进行术前宫颈成熟处理。进行逻辑回归以控制混杂因素。我们检测并发症发生率从10%翻倍至20%的统计效能为90%。两组之间胎膜破裂持续时间或产程长度无显著差异。剖宫产率、剖宫产指征、胎粪黏稠情况、硬膜外麻醉使用情况、羊膜炎或母婴发病率方面均未检测到显著差异。两组均无子宫破裂病例。对于有剖宫产史的患者，PgE2凝胶的使用安全性和有效性与未产妇相同。
