阴道迪诺普罗斯插入剂与两种不同的口服美索普罗斯治疗方案进行了比较,用于在无孕和多孕妇女中诱导分娩
Damaris Erhardt1, Anda-Petronela Radan1, Jérôme Mathis2
1Department of Obstetrics and Feto-maternal Medicine, University Hospital of Bern, University of Bern, Bern, Switzerland.
Acta obstetricia et gynecologica Scandinavica
|September 2, 2024
概括
口服misoprostol (25μg) 每4小时一次的治疗效果不如阴道dinoprostone (10mg) 的治疗效果,特别是在多胎妇女中. 然而,口服mizoprostol疗法显示出较少的副作用,如染液体和剖腹产.
科学领域:
- 产科和妇科 产科和妇科
- 生殖医学 生殖医学
- 临床药理学 临床药理学
背景情况:
- 产业诱导协议有很大差异,对阴道迪诺普罗斯与不同口服米索普罗斯剂量的比较数据有限.
- 均等性是影响分娩诱导结果的关键因素,但它对比较这些药物的影响还未得到充分研究.
研究的目的:
- 为了比较10毫克阴道dinoprostone插入剂与25微克口服mizoprostol每2或4小时服用一次用于分娩诱导的疗效和安全性.
- 为了分析这些比较,按患者平价分层分析 (无双与多双).
主要方法:
- 在两家医院对607名参与者的回顾性队列研究.
- 主要结果:从诱导到分娩的时间.
- 二次结果:分娩方式,孕产妇和胎儿安全,按平价分层.
主要成果:
- 两种口服mizoprostol疗程的结果是,与阴道dinoprostone相比,分娩的时间更短 (p < 0.001和p = 0.014).
- 口服mizoprostol疗法与阴道dinoprostone相比,与阴道dinoprostone相比,染液体和剖腹产的病例显著减少,即使经过对混因素的调整.
- 口服mizoprostol q4h和阴道dinoprostone之间的有效性差异在调整了对等性和诱导指示后是显著的,特别是在多孕女性中.
结论:
- 口服mizoprostol 25μg q4h在调整为均性和适应性时,对于引发分娩的有效性低于阴道dinoprostone 10mg,特别是在多胎妇女中.
- 口服mizoprostol疗法似乎比阴道dinoprostone更安全,染液体和剖腹产的发生率较低.
- 建议采用个性化劳动诱导策略,考虑平价,指示,毕晓普得分和患者偏好.
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