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首页> 外文期刊>Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology >Comparison of intracervical Foley catheter used alone or combined with a single dose of dinoprostone gel for cervical ripening: a randomised study
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Comparison of intracervical Foley catheter used alone or combined with a single dose of dinoprostone gel for cervical ripening: a randomised study

机译：单独使用的颈内部福利导管的比较或与单剂量Dinoprostore凝胶结合用于颈椎成熟：随机研究

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Prostaglandins and intracervical catheters are similarly effective for cervical ripening and for an induction of labour (IOL). Studies comparing the combined use with either method alone have administered repetitive doses of prostaglandins vaginally, which may increase the risk of tachysystole and chorioamnionitis. These disadvantages may be offset by co-administering a single dose of prostaglandin. Women (n=110) planned for IOL, 37weeks of gestation and with a Bishop Score of 6 were randomised into two groups: intracervical Foley catheter alone or combined with dinoprostone gel (0.5mg) for 12hours followed by oxytocin. The primary outcome was the IDI and the others were: change in Bishop Score, caesarean section (CS) requirement, any complications and neonatal outcome. The baseline Bishop was 4 in all and >80% were nulliparous. The post-ripening Bishop was significantly higher (6.67 vs. 5.98; p=.045) and the IDI was significantly lower in the combined group (16hours and 16minutes vs. 20hours 44minutes, p=.002). The CS rate was similar (29.1 vs. 25.5%; p=.669). No woman had hyperstimulation or chorioamnionitis and the neonatal outcomes were similar. Thus, co-administering one dose of an intracervical PGE2 gel with Foley was superior to Foley alone for cervical ripening and IOL.Impact statementWhat is already known on this subject? Prostaglandins and intracervical balloon catheters used individually are similarly effective for ripening an unfavourable cervix prior to the induction of labour (IOL). A few studies which have compared their found it to result in a shorter cervical ripening time and induction delivery interval (IDI) as compared to prostaglandins alone, though chorioamnionitis was a concern. When compared to balloon catheter used alone, combined use was either similarly or more effective. The studies comparing combined use with either method used alone have administered repetitive doses of prostaglandins vaginally, which may increase the risk of tachysystole, and possibly of chorioamnionitis. Co-administering a single dose of prostaglandin with a balloon catheter may offset these disadvantages.What do the results of this study add? A combined method for cervical ripening using a single dose of intracervical dinoprostone gel (PGE2, 0.5mg) coadministered with an intracervical Foley catheter was superior to Foley catheter alone. The combined method improved the Bishop score after 12hours and reduced the IDI significantly compared to the Foley catheter alone; while the caesarean rate and neonatal outcomes were similar. No woman had chorioamnionits or hyperstimulation.What are the implications of these findings for clinical practice and/or further research? The combined methods for cervical ripening should be compared to individual methods in more women, and the combinations may explore the use of other single use prostaglandins like the dinoprostone vaginal insert or misoprostol tablets.
机译：前列腺素和颈动物导管类似地对宫颈成熟和诱导劳​​动（IOL）的有效性。单独使用与任一方法的组合使用的研究表明，阴道前列腺素的重复剂量，这可能会增加麻醉术和绒毛炎的风险。这些缺点可以通过共同施用单剂量的前列腺素来抵消。计划适用于IOL，37周的妊娠和主教得分6的女性（N = 110）被随机分为两组：单独的血管内粪便导管或与Dinoprostone凝胶（0.5mg）合并12小时，然后用催产素。主要结果是IDI和其他结果是：主教分数的变化，剖腹产（CS）要求，任何并发症和新生儿结果。基线主教是4的，> 80％是无污染的。后果后主教显着高（6.67 vs.5.98; p = .045），合并组中的IDI显着较低（16小时和16分钟与20hours 44分钟，p = .002）。 CS率相似（29.1与25.5％; p = .669）。没有女性具有过度刺激或绒毛炎，新生儿结果是相似的。因此，将一种剂量的一种剂量的一种剂量的血管型PGE2凝胶具有优于单独的粪便，用于颈椎成熟和IOL.impact声明在该主题上已经已知？前列腺素和颈动脉管导管在诱导劳动（IOL）之前，与弥合不利的子宫颈同样使用的同样有效。与单独的前列腺素相比，少数几种研究其发现其发现其导致颈椎成熟时间和感应递送间隔（IDI），尽管绒毛膜炎是一个问题。与单独使用的球囊导管相比，组合使用类似或更有效。将组合使用与单独使用的任一方法进行比较的研究已经施用了重复剂量的前列腺素，这可能会增加Tachysystole的风险，并且可能是绒毛膜炎。与气球导管共同施用一剂前列腺素可以抵消这些缺点。本研究的结果添加了什么？使用单个剂量的宫颈成熟的组合方法使用单剂量的intaceracticeDinoprostone凝胶（PGE2，0.5mg）与内部粪便导管共同升压到福利导管上。合并的方法改善了12小时后的主教得分，并与单独的Foley导管相比显着减少了IDI;虽然剖腹产率和新生儿结果是相似的。没有女人患有chorioamnionits或过度刺激。这些发现对临床实践和/或进一步研究的影响是什么？应将宫颈成熟的组合方法与更多女性中的个体方法进行比较，并且组合可以探讨其他单一使用前列腺素，如Dinoprostore阴道插入物或米索前列醇片剂。

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