Malik N, Gittens L, Gonzalez D, Bardeguez A, Ganesh V, Apuzzio J
Department of Obstetrics and Gynecology, University of Medicine and Dentistry, New Jersey Medical School, Newark, USA.
Obstet Gynecol. 1996 Oct;88(4 Pt 1):540-3. doi: 10.1016/0029-7844(96)00266-9.
To compare the rates of clinical amnionitis and endometritis in patients with premature rupture of membranes (PROM), using endocervical prostaglandin E2 (PGE2) gel for induction of labor versus immediate oxytocin induction of labor.
We randomized 118 patients to receive either endocervical 0.5 mg of PGE2 gel (study group) or immediate oxytocin induction of labor (control group). If labor was not established in the group receiving PGE2 gel in 24 hours, intravenous oxytocin was given in incremental doses. The rates of clinical amnionitis and endometritis in the two groups were analyzed. Also compared were hours of labor, duration of rupture of membranes and number of vaginal examinations. Student t test, chi 2, or Wilcoxon rank-sum test were used for statistical analysis, as appropriate. P < .05 was considered significant.
The rates of clinical amnionitis were 5.3% in the PGE2 group and 8% in the control group. Endometritis developed in 1.7% of PGE2 patients and 3.2% of controls. These differences in maternal infection rates were not statistically significant. The two groups were comparable with respect to age, parity, and antepartum group B streptococcal colonization. No significant differences in hours of labor, duration of ruptured membranes, or vaginal examinations were observed. Neonatal outcome data (mean birth weight, Apgar scores at 1 and 5 minutes, Apgar score less than 7 at 5 minutes) were not statistically significant.
Endocervical placement of 0.5 mg of PGE2 gel does not increase the incidence of clinical amnionitis and endometritis in patients with PROM at term when compared with immediate induction of labor with oxytocin.
比较胎膜早破（PROM）患者使用宫颈内前列腺素E2（PGE2）凝胶引产与立即使用缩宫素引产的临床羊膜炎和子宫内膜炎发生率。
我们将118例患者随机分为两组，一组接受宫颈内0.5mg PGE2凝胶（研究组），另一组立即使用缩宫素引产（对照组）。如果接受PGE2凝胶的组在24小时内未发动分娩，则给予递增剂量的静脉缩宫素。分析两组的临床羊膜炎和子宫内膜炎发生率。还比较了产程时间、胎膜破裂持续时间和阴道检查次数。根据情况，采用学生t检验、卡方检验或Wilcoxon秩和检验进行统计分析。P<0.05被认为具有统计学意义。
PGE2组临床羊膜炎发生率为5.3%，对照组为8%。PGE2组患者子宫内膜炎发生率为1.7%，对照组为3.2%。这些产妇感染率的差异无统计学意义。两组在年龄、产次和产前B族链球菌定植方面具有可比性。在产程时间、胎膜破裂持续时间或阴道检查方面未观察到显著差异。新生儿结局数据（平均出生体重、1分钟和5分钟时的阿氏评分、5分钟时阿氏评分低于7分）无统计学意义。
与立即使用缩宫素引产相比，足月胎膜早破患者宫颈内放置0.5mg PGE2凝胶不会增加临床羊膜炎和子宫内膜炎的发生率。
