Williams M C, Krammer J, O'Brien W F
Department of Obstetrics and Gynecology, University of South Florida, Tampa 33606, USA.
Obstet Gynecol. 1997 Nov;90(5):784-9. doi: 10.1016/S0029-7844(97)00415-8.
To compare cervical dilation and the Bishop score as correlates of successful labor induction and vaginal delivery and to determine whether the prognosis of post-ripening cervical characteristics varies with the method of ripening used.
Four hundred forty-three women with Bishop scores less than 9 who required induction of labor were assigned randomly to cervical ripening with prostaglandin E2 gel or hygroscopic dilation. The Bishop score and its component characteristics were evaluated as univariate correlates of successful induction of labor and vaginal delivery and then were assessed using logistic regression to adjust for other maternal and fetal factors. The differences in the association between method of ripening and successful labor induction were evaluated relative to pre-ripening and post-ripening cervical examination characteristics.
Cervical dilation was a better correlate of successful labor induction and vaginal delivery than was the Bishop score, even after exclusion of patients with initial Bishop scores greater than 6 and dilation greater than 3.0. Both ripening methods yielded similar success in labor induction and vaginal delivery, but when categorized by post-ripening cervical examinations, patients undergoing hygroscopic ripening had lower rates of successful labor induction and vaginal delivery.
Cervical dilation is a better predictor of successful labor induction and vaginal delivery than either the Bishop score or any other Bishop score component characteristic. The likelihood of successful labor induction and vaginal delivery based on post-ripening cervical characteristics varies by the ripening method used.
比较宫颈扩张和Bishop评分作为引产成功及阴道分娩相关因素的情况，并确定成熟后宫颈特征的预后是否因所用的成熟方法而异。
443名Bishop评分低于9且需要引产的女性被随机分配接受前列腺素E2凝胶宫颈成熟或水囊扩张。将Bishop评分及其组成特征作为引产成功和阴道分娩的单变量相关因素进行评估，然后使用逻辑回归分析来调整其他母体和胎儿因素。相对于成熟前和成熟后的宫颈检查特征，评估成熟方法与引产成功之间关联的差异。
即使排除初始Bishop评分大于6且宫颈扩张大于3.0的患者，宫颈扩张仍是引产成功和阴道分娩比Bishop评分更好的相关因素。两种成熟方法在引产和阴道分娩方面成功率相似，但根据成熟后宫颈检查进行分类时，接受水囊成熟的患者引产成功和阴道分娩的发生率较低。
宫颈扩张比Bishop评分或任何其他Bishop评分组成特征更能预测引产成功和阴道分娩。基于成熟后宫颈特征的引产成功和阴道分娩的可能性因所用的成熟方法而异。
