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首页> 外文期刊>Obstetrics and Gynecology: Journal of the American College of Obstetricians and Gynecologists >Combination of foley bulb and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and labor induction: A randomized controlled trial
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Combination of foley bulb and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and labor induction: A randomized controlled trial

机译：foley球囊和阴道米索前列醇联合使用相比单独使用阴道米索前列醇进行宫颈成熟和引产的随机对照试验

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Objective: To test the hypothesis that use of the Foley bulb plus vaginal misoprostol will result in shorter induction-to-delivery time compared with vaginal misoprostol alone. Methods: We randomized 123 women undergoing induction of labor with singleton pregnancies at 24 weeks of gestation or greater with an unfavorable cervix (Bishop score 6 or lower) to Foley bulb plus vaginal misoprostol (n=56) or vaginal misoprostol alone (n=61). Women with fetal malpresentation, multifetal gestation, spontaneous labor, contraindication to prostaglandins, nonreassuring fetal heart rate tracing, intrauterine growth restriction, anomalous fetus, fetal demise, or previous cesarean delivery or other significant uterine surgery were excluded. The primary outcome measure was induction-to-delivery time. Secondary outcomes were mode of delivery, tachysystole with fetal decelerations, terbutaline use, postpartum hemorrhage, chorioamnionitis, neonatal Apgar scores, and neonatal intensive care unit admission. Analysis followed the intention-to-treat principle. Results: The mean induction-to-delivery time was shorter with the combination of the Foley bulb and vaginal misoprostol when compared with vaginal misoprostol alone (15.3±6.5 compared with 18.3±8.7 hours, difference-3.1 hours, 95% confidence interval [CI]-5.9 to-0.30). The combination also resulted in shorter induction to complete cervical dilation time (13.7±5.9 compared with 17.1±8.7 hours, difference-3.5 hours, 95% CI-6.7 to-0.4). There were no differences in labor complications or adverse neonatal and maternal outcomes. Conclusion: A combination of the Foley bulb and vaginal misoprostol resulted in a shorter induction-to-delivery time when compared with vaginal misoprostol alone without increasing labor complications.
机译：目的：为了检验以下假设：与单独使用阴道米索前列醇相比，使用Foley球囊加阴道米索前列醇会缩短诱导到分娩的时间。方法：我们将123名在妊娠24周或以上单胎妊娠且宫颈不良（Bishop评分6或更低）的引产的妇女随机分为Foley球囊加阴道米索前列醇（n = 56）或单独使用阴道米索前列醇（n = 61） ）。排除胎儿畸形，多胎妊娠，自发分娩，前列腺素禁忌症，胎儿心率追踪不安定，宫内生长受限，胎儿异常，胎儿死亡，或先前剖宫产或其他重要子宫手术的妇女。主要结局指标是诱导交付时间。次要结局为分娩方式，伴有胎儿减速的心动过速，使用特布他林，产后出血，绒毛膜羊膜炎，新生儿Apgar评分和新生儿重症监护病房入院。分析遵循意向性处理原则。结果：与单独使用米索前列醇相比，Foley球囊和阴道米索前列醇联合使用的平均诱导分娩时间要短（15.3±6.5则与18.3±8.7小时相比，相差3.1小时，置信区间为95％[CI ] -5.9至-0.30）。该组合还导致更短的诱导完成完全的宫颈扩张时间（13.7±5.9，而17.1±8.7小时，差-3.5小时，95％CI-6.7至-0.4）。分娩并发症或不良的新生儿和产妇结局无差异。结论：与单独使用阴道米索前列醇相比，Foley球囊和阴道米索前列醇的组合可缩短引产时间，而不会增加劳动并发症。

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