Carlan S J, O'Brien W F, Logan S
Department of Obstetrics and Gynecology, Arnold Palmer Hospital for Children and Women, Division of Orlando Regional Healthcare System, Florida 32806, USA.
Prostaglandins. 1996 Sep;52(3):237-46. doi: 10.1016/s0090-6980(96)00086-x.
To determine if prostaglandin (PG) E2 cervical ripening is safe and effective in high-risk preterm pregnant women who do not have an indication for immediate delivery.
This was a retrospective case-control study of preterm pregnant women treated with sequential PGE2 gel between 3/1/92 and 3/1/95. Study subjects were between 24 and 36 weeks gestation, had intact membranes, and complications requiring inpatient monitoring but not immediate delivery. PGE2 gel was inserted serially until either maternal or fetal deterioration required intervention, fetal maturity was achieved, a Bishop > or = 7 was reached, or the patient improved and was discharged. Control subjects were matched for inclusion criteria and diagnoses on admission.
A total of 22 study and 22 control patients were evaluated. The gestational age at admission was 32.3 +/- 2.8 versus 31.8 +/- 2.9 weeks. The mean number of PGE2 gel applications was 11.6 over a mean of 5.0 days. Intervention during ripening was required in 11 (50%). A Bishop score > or = 7 without labor was achieved in 11 (50%), and labor during the ripening process occurred in 2 (9%). The mean time from Bishop > or = 7 to delivery was 2.6 days. The total cesarean delivery rate was 10 (45%) versus 15 (68%), in the control group (P = NS). Neonatal outcomes were similar.
Sequential PGE2 gel cervical ripening when used in preterm pregnant women improves the Bishop score, and has a low incidence of spontaneous preterm labor.
确定前列腺素（PG）E2用于宫颈成熟在无立即分娩指征的高危早产孕妇中是否安全有效。
这是一项对1992年3月1日至1995年3月1日期间接受序贯PGE2凝胶治疗的早产孕妇进行的回顾性病例对照研究。研究对象孕周在24至36周之间，胎膜完整，有需要住院监测但无需立即分娩的并发症。连续插入PGE2凝胶，直至出现母体或胎儿情况恶化需要干预、达到胎儿成熟、Bishop评分≥7分，或患者情况改善并出院。对照对象根据纳入标准和入院诊断进行匹配。
共评估了22例研究对象和22例对照患者。入院时孕周分别为32.3±2.8周和31.8±2.9周。PGE2凝胶的平均应用次数为11.6次，平均持续5.0天。成熟过程中11例（50%）需要干预。11例（50%）在未临产情况下Bishop评分≥7分，成熟过程中2例（9%）临产。从Bishop评分≥7分到分娩的平均时间为2.6天。研究组剖宫产率为10例（45%），对照组为15例（68%）（P=无显著差异）。新生儿结局相似。
序贯PGE2凝胶用于宫颈成熟可改善早产孕妇的Bishop评分，自发性早产发生率低。
