目的:本研究的目的是评估在低风险孕妇人群中使用阴道米索前列醇引产的成功率和预测因素。
方法:对196名孕妇进行了前瞻性队列研究。罗布森分类的第2组和第4组接受阴道米索前列醇引产(每6小时25μg片剂,多达4片,最长24小时)。引产的成功被认为是阴道分娩的成功。二元逻辑回归用于确定阴道米索前列醇成功引产的最佳预测因素。
结果:在分析的所有孕妇中,140例(71.4%)成功,56例(28.6%)不成功。成功引产的孕妇怀孕次数较多(1.69vs.1.36,p=0.023),较高的交货数量(0.57与0.19,p<0.001),更高的Bishop分数(2.0vs.1.38,p=0.002),和更低的米索前列醇25μg片剂(2.18vs.2.57,p=0.031)。以前没有分娩[x2(1)=3.14,比值比(OR):0.24,95%置信区间(CI):0.10-0.57,R2Nagelkerke:0.91,p=0.001]和以前一次分娩的存在[x2(1)=6.0,OR:3.40,95%CI:1.13-10.16,R2Nagelkerke:0.043,p=0.029]是阴道前列腺醇成功引产的
结论:在低风险人群中观察到使用阴道米索前列醇的引产成功率很高,主要发生在经胎和胎龄>41周。以前没有分娩降低了引产的成功率,而之前的一次分娩增加了引产的成功率。
OBJECTIVE: The aim of this study was to evaluate the success rate and predictors of labor induction using vaginal
misoprostol in a low-risk pregnant women population.
METHODS: A prospective cohort study was carried out with 196 pregnant women. Groups 2 and 4 of the Robson Classification admitted for induction of labor with vaginal
misoprostol (25 μg tablets every 6 h, up to 4 tablets, for a maximum of 24 h). The success of labor induction was considered the achievement of vaginal delivery. Binary logistic regression was used to determine the best predictors of successful induction of labor with vaginal
misoprostol.
RESULTS: Of all the pregnant women analyzed, 140 (71.4%) were successful and 56 (28.6%) were unsuccessful. Pregnant women who achieved successful induction had a higher number of pregnancies (1.69 vs. 1.36, p=0.023), a higher number of deliveries (0.57 vs. 0.19, p<0.001), a higher Bishop score (2.0 vs. 1.38, p=0.002), and lower misoprostol 25 μg tablets (2.18 vs. 2.57, p=0.031). No previous deliveries [x2(1)=3.14, odds ratio (OR): 0.24, 95% confidence interval (CI): 0.10-0.57, R2 Nagelkerke: 0.91, p=0.001] and the presence of one previous delivery [x2(1)=6.0, OR: 3.40, 95% CI: 1.13-10.16, R2 Nagelkerke: 0.043, p=0.029] were significant predictors of successful induction of labor with vaginal
misoprostol.
CONCLUSIONS: A high rate of labor induction success using vaginal
misoprostol in a low-risk population was observed, mainly in multiparous and with gestational age>41 weeks. No previous delivery decreased the success of labor induction, while one previous delivery increased the success of labor induction.