Kadanali S, Küçüközkan T, Zor N, Kumtepe Y
Department of Obstetrics and Gynecology, Atatürk University, Erzurum, Turkey.
Int J Gynaecol Obstet. 1996 Nov;55(2):99-104. doi: 10.1016/s0020-7292(96)02710-5.
To compare the efficacy and safety of intravaginal and oral misoprostol vs. oxytocin/prostaglandin E2 (PGE2) gel for third trimester labor induction.
Two hundred twenty-four pregnant women were randomized to induction of labor either with misoprostol or oxytocin and PGE2 gel. Patients in the misoprostol group (n = 112) received 100 micrograms intravaginal misoprostol followed by 100 micrograms p.o. every 2 h. The oxytocin/PGE2 group consisted of 112 patients who underwent PGE2 cervical instillation 6 h before continuous oxytocin infusion. The perinatal, intrapartum and neonatal characteristics of both groups were determined.
Induction to active phase of labor was successfully achieved in 96 women (85.7%) in the misoprostol group vs. 86 women (76.8%) in the oxytocin/PGE2 group, but the drug initiation-delivery interval was significantly shorter in the misoprostol group (9.2 +/- 2.4 h) than in the oxytocin/PGE2 group (15.2 +/- 3.2 h, P < 0.001). The incidence of adverse intrapartum outcomes was similar for both methods. Intravaginal misoprostol 100 micrograms followed by a single oral dose of 100 micrograms misoprostol safely produced labor and a vaginal delivery in 70% of patients. More than three tablets were required in only 10% of patients. There was a higher prevalence of cesarean section for failed induction in the oxytocin/PGE2 group than in the misoprostol group (13.4 vs. 6.3%, P < 0.001). The neonatal outcomes of both groups were also similar.
Misoprostol is significantly more effective for labor induction than oxytocin/PGE2 gel. The maternal intrapartum and neonatal outcomes were the same for both induction regimens. From a clinical and perinatal perspective, misoprostol is an acceptable choice for labor induction.
比较阴道内及口服米索前列醇与缩宫素/前列腺素E2（PGE2）凝胶用于晚期妊娠引产的有效性和安全性。
224名孕妇被随机分为米索前列醇引产组或缩宫素与PGE2凝胶引产组。米索前列醇组（n = 112）患者阴道内给予100微克米索前列醇，随后每2小时口服100微克。缩宫素/PGE2组由112名患者组成，这些患者在持续输注缩宫素前6小时进行PGE2宫颈灌注。确定两组的围产期、产时及新生儿特征。
米索前列醇组96名女性（85.7%）成功引产至活跃期，而缩宫素/PGE2组为86名女性（76.8%），但米索前列醇组从用药开始至分娩的间隔时间显著短于缩宫素/PGE2组（9.2±2.4小时对15.2±3.2小时，P<0.001）。两种方法的产时不良结局发生率相似。阴道内给予100微克米索前列醇，随后单次口服100微克米索前列醇，70%的患者安全引产并经阴道分娩。仅10%的患者需要超过三片药物。缩宫素/PGE2组引产失败后剖宫产的发生率高于米索前列醇组（13.4%对6.3%，P<0.001）。两组的新生儿结局也相似。
米索前列醇引产比缩宫素/PGE2凝胶显著更有效。两种引产方案的产妇产时及新生儿结局相同。从临床和围产期角度来看，米索前列醇是引产的可接受选择。
