宫成熟气球与口服mizoprostol用于在小到妊娠年龄诱导分娩:回顾性多中心研究
G Zaccaria1, V Dutemeyer2, A Carlin3
1Department of Obstetrics and Gynecology, ARNAS Civico Hospital, Palermo, Italy.
概括
与机械宫成熟相比,口服mizoprostol用于妊娠年龄小 (SGA) 怀孕的分娩诱导并没有增加剖腹产 (CD) 的风险. 这种方法减少了高风险怀孕中手术干预和劳动增强需求.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产周研究 产周研究
背景情况:
- 诱导分娩 (IOL) 是常见的怀孕与小为妊娠年龄 (SGA) 或胎儿生长限制 (FGR).
- 对比宫成熟方法对于优化这些高风险怀孕中母亲和新生儿的结果至关重要.
研究的目的:
- 为了比较使用口服mizoprostol与使用宫成熟气球 (CRB) 的机械宫成熟的IOL的孕产妇和新生儿结局.
- 评估这些方法在单独怀孕中复杂的SGA,包括晚期发作的FGR.
主要方法:
- 追溯多中心队列研究,对848名单独怀孕的妇女进行,估计胎儿体重<10百分点.
- 在怀孕≥37周时,口服mizoprostol组和仅CRB组对IOL进行比较.
- 使用治疗权重的逆概率和双重可靠估计的调整分析.
主要成果:
- 在口服mizoprostol和仅使用CRB的组之间,剖腹产率 (CD) 没有显著差异 (aOR,1.29).
- 口服mizoprostol组的手术性阴道分娩 (OVD) (aOR,0.33) 和催产素增强 (aOR,0.04) 的比率明显较低.
- 用米索普罗斯托尔时,子宫太基斯托尔较为频繁,但并没有增加胎儿痛苦或新生儿不良后果的CD.
结论:
- 口服mizoprostol是SGA/FGR怀孕中IOL的安全和有效选择,减少了手术干预和增强.
- 研究结果支持在这种高风险人群中使用口服mizoprostol,但需要进一步的随机对照试验.
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