Fletcher H M, Mitchell S, Simeon D, Frederick J, Brown D
Department of Obstetrics and Gynaecology, University of the West Indies, Kingston, Jamaica.
Br J Obstet Gynaecol. 1993 Jul;100(7):641-4. doi: 10.1111/j.1471-0528.1993.tb14230.x.
To determine if misoprostol (exogenous prostaglandin E1 PGE1) used vaginally was of value in improving the Bishop score, leading to an early safe vaginal delivery in women in whom the cervix is unripe and delivery is indicated.
A double-blind clinical trial.
Antenatal and labour wards of the University Hospital of the West Indies, Jamaica.
Forty-five women in the third trimester with various obstetric indications for induction of labour and with no contra-indications to prostaglandins.
The women were randomly assigned to receive treatment or a placebo. The treated group had 100 micrograms misoprostol inserted vaginally while the placebo was similarly inserted.
Efficacy of the misoprostol was measured by the increase in the Bishop score 12 h after giving the treatment, the time between insertion and delivery, the need for oxytocin, and the outcome of the pregnancy.
The prostaglandin was superior to the placebo in ripening the cervix and inducing labour. The change in Bishop score was 5.3 in the misoprostol group compared with 1.5 in the placebo group (P < 0.001). The mean time from insertion to delivery was 15.6 h in the former while it was 43.2 h in the placebo group (P < or = 0.001). The need for oxytocin was also significantly less in the women receiving the prostaglandin compared with those who received the placebo (29% vs 62%, P < 0.02). There was no difference in the two groups in the delivery outcome in terms of complications, Apgar scores and mode of delivery.
Intravaginal misoprostol is an effective and cheap method of inducing labour in the third trimester.
确定阴道使用米索前列醇（外源性前列腺素E1，PGE1）是否有助于提高Bishop评分，从而使宫颈未成熟但有引产指征的妇女能早期安全地经阴道分娩。
双盲临床试验。
牙买加西印度群岛大学医院的产前病房和分娩病房。
45名孕晚期妇女，有各种引产的产科指征且无前列腺素使用禁忌证。
将这些妇女随机分为治疗组或安慰剂组。治疗组阴道置入100微克米索前列醇，安慰剂组则置入类似物。
通过治疗后12小时Bishop评分的增加、置入药物至分娩的时间、催产素的使用需求以及妊娠结局来衡量米索前列醇的疗效。
前列腺素在宫颈成熟和引产方面优于安慰剂。米索前列醇组Bishop评分变化为5.3，而安慰剂组为1.5（P<0.001）。前者从置入药物到分娩的平均时间为15.6小时，而安慰剂组为43.2小时（P≤0.001）。与接受安慰剂的妇女相比，接受前列腺素的妇女对催产素的需求也显著减少（29%对62%，P<0.02）。两组在分娩结局的并发症、阿氏评分和分娩方式方面无差异。
阴道内使用米索前列醇是孕晚期引产的一种有效且廉价的方法。
