Background: Labor induction has a low success rate, especially in primiparas with unruptured membranes. Previous studies focused on pregnant women with unruptured membranes, but none specifically targeted primiparas. ...Background: Labor induction has a low success rate, especially in primiparas with unruptured membranes. Previous studies focused on pregnant women with unruptured membranes, but none specifically targeted primiparas. Aims: To compare the effectiveness of a controlled-release dinoprostone vaginal delivery system for cervical dilatation (PROPESS) with that of mechanical dilation for labor induction in primiparous women with unruptured membranes. Materials and Methods: We retrospectively analyzed the data of 90 primiparas with unruptured membranes (41 and 49 in the PROPESS and mechanical dilation groups, respectively). The primary outcome was the cesarean section (CS) rate. The secondary outcomes were the prevalence of vaginal delivery within 12 or 24 h after the initial insertion, oxytocin usage rate, chorioamnionitis, additional use of mechanical dilation in the PROPESS group, and neonatal outcomes. Results: The CS rate was significantly lower in the PROPESS group than in the mechanical dilation group (p = 0.02). A total of 13 patients (31.7%) delivered within 24 h with PROPESS alone, indicating a significantly higher rate of delivery within 24 h in the PROPESS group (p = 0.02). Fewer patients required additional oxytocin in the PROPESS group than in the mechanical dilation group (p = 0.001). However, 14 (34%) patients in the PROPESS group required additional mechanical cervical dilation, resulting in a longer time to delivery than mechanical dilation. Conclusions: PROPESS significantly reduced CS rates and increased delivery rates 24 h after the initial insertion in primiparas with unruptured membranes compared to mechanical dilatation. However, failure to respond to PROPESS resulted in an overall longer delivery time than that of the conventional mechanical dilation group;therefore, identifying predictors of response to PROPESS is necessary.展开更多
目的研究30 m L、80 m L及150 m L三种容量小水囊引产对足月妊娠促宫颈成熟所产生的临床效果。方法选取2014年10月至2016年10月间于南京市江宁医院行引产治疗的宫颈条件不成熟足月妊娠患者177例为观察对象。采用随机数表法将其分为30 m ...目的研究30 m L、80 m L及150 m L三种容量小水囊引产对足月妊娠促宫颈成熟所产生的临床效果。方法选取2014年10月至2016年10月间于南京市江宁医院行引产治疗的宫颈条件不成熟足月妊娠患者177例为观察对象。采用随机数表法将其分为30 m L组、80 m L及150 m L组,各59例,分别接受30 m L、80 m L及150 m L无菌Na Cl溶液的小水囊引产治疗。研究各组患者促宫颈成熟效果评估、宫颈评分、分娩情况及并发症发生情况,以评估上述三种方案促宫颈成熟的临床效果。结果 30 m L组、80 m L组及150 m L组患者促宫颈成熟效果评估中,有效患者人数所占组别总人数比重分别为84.75%、96.61%和98.31%,80 m L及150 m L组与30 m L组比较差异有统计学意义(P<0.05);80 m L及150 m L组患者引产后宫颈评分远高于30 m L组,且差异具有统计学意义(P<0.05);经阴道分娩患者人数所占比重、引产至临产时间和第一产程时间,80 m L和150 m L组患者表现情况均明显优于30 m L组,且差异具有统计学意义(P<0.05);三组患者在新生儿体质量和新生儿窒息率方面比较差异均无统计学意义(P>0.05);150 m L组患者脐带脱垂率远高于30 m L组和80 m L组,差异有统计学意义(P<0.05),而30 m L组和80 m L组比较差异无统计学意义(P>0.05);三组患者中出现并发症人数所占组别总人数比重差异无统计学意义(P>0.05)。结论 80 m L小水囊引产治疗方案的综合治疗效果比30 m L和150 m L更突出,且副作用更小。展开更多
文摘Background: Labor induction has a low success rate, especially in primiparas with unruptured membranes. Previous studies focused on pregnant women with unruptured membranes, but none specifically targeted primiparas. Aims: To compare the effectiveness of a controlled-release dinoprostone vaginal delivery system for cervical dilatation (PROPESS) with that of mechanical dilation for labor induction in primiparous women with unruptured membranes. Materials and Methods: We retrospectively analyzed the data of 90 primiparas with unruptured membranes (41 and 49 in the PROPESS and mechanical dilation groups, respectively). The primary outcome was the cesarean section (CS) rate. The secondary outcomes were the prevalence of vaginal delivery within 12 or 24 h after the initial insertion, oxytocin usage rate, chorioamnionitis, additional use of mechanical dilation in the PROPESS group, and neonatal outcomes. Results: The CS rate was significantly lower in the PROPESS group than in the mechanical dilation group (p = 0.02). A total of 13 patients (31.7%) delivered within 24 h with PROPESS alone, indicating a significantly higher rate of delivery within 24 h in the PROPESS group (p = 0.02). Fewer patients required additional oxytocin in the PROPESS group than in the mechanical dilation group (p = 0.001). However, 14 (34%) patients in the PROPESS group required additional mechanical cervical dilation, resulting in a longer time to delivery than mechanical dilation. Conclusions: PROPESS significantly reduced CS rates and increased delivery rates 24 h after the initial insertion in primiparas with unruptured membranes compared to mechanical dilatation. However, failure to respond to PROPESS resulted in an overall longer delivery time than that of the conventional mechanical dilation group;therefore, identifying predictors of response to PROPESS is necessary.
文摘目的研究30 m L、80 m L及150 m L三种容量小水囊引产对足月妊娠促宫颈成熟所产生的临床效果。方法选取2014年10月至2016年10月间于南京市江宁医院行引产治疗的宫颈条件不成熟足月妊娠患者177例为观察对象。采用随机数表法将其分为30 m L组、80 m L及150 m L组,各59例,分别接受30 m L、80 m L及150 m L无菌Na Cl溶液的小水囊引产治疗。研究各组患者促宫颈成熟效果评估、宫颈评分、分娩情况及并发症发生情况,以评估上述三种方案促宫颈成熟的临床效果。结果 30 m L组、80 m L组及150 m L组患者促宫颈成熟效果评估中,有效患者人数所占组别总人数比重分别为84.75%、96.61%和98.31%,80 m L及150 m L组与30 m L组比较差异有统计学意义(P<0.05);80 m L及150 m L组患者引产后宫颈评分远高于30 m L组,且差异具有统计学意义(P<0.05);经阴道分娩患者人数所占比重、引产至临产时间和第一产程时间,80 m L和150 m L组患者表现情况均明显优于30 m L组,且差异具有统计学意义(P<0.05);三组患者在新生儿体质量和新生儿窒息率方面比较差异均无统计学意义(P>0.05);150 m L组患者脐带脱垂率远高于30 m L组和80 m L组,差异有统计学意义(P<0.05),而30 m L组和80 m L组比较差异无统计学意义(P>0.05);三组患者中出现并发症人数所占组别总人数比重差异无统计学意义(P>0.05)。结论 80 m L小水囊引产治疗方案的综合治疗效果比30 m L和150 m L更突出,且副作用更小。
