Cervical Ripening With Prostaglandin Gel andHygroscopic Dilators

[摘要] Objective:To study the effectiveness and morbidity of adding hygroscopic cervical dilators to prostaglandingel for cervical ripening and labor induction.Study design:Patients of at least 34 weeks’ gestation with a medical indication for induction oflabor and with a modified Bishop score of 5 or less were randomized to receive either prostaglandingel or prostaglandin gel with hygroscopic cervical dilators. Primary outcomes were time to delivery,change in cervical score, and infection. Secondary outcomes included cesarean delivery rate anddeliveries before 24 hours of induction. Continuous variables were analyzed by Wilcoxon sum ranktest and categorical data by chi-square or Fisher exact test, withP< 0.05 being significant.Results:Seventeen patients were randomized to intracervical prostaglandin alone and 23 patientsreceived intracervical prostaglandin plus hygroscopic dilators. No demographic differences werenoted between the groups. After six hours of ripening, the combined group achieved a greaterchange in Bishop score (3.6 vs. 2.1,P= 0.007) and tended to have a shorter induction time (21.7 vs. 26.4 hours,P= 0.085). The combined therapy group had a higher infection rate than the prostaglandin-only group (59% vs. 12%,P= 0.003).Conclusion:Combining cervical dilators with prostaglandin gel provides more effective cervicalripening and a more rapid induction to delivery interval than prostaglandin alone but with a significantand prohibitive rate of infection.

[学科分类] 妇产科学