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1.
Ellen L Mozurkewich Julie L Chilimigras Deborah R Berman Uma C Perni Vivian C Romero Valerie J King Kristie L Keeton 《BMC pregnancy and childbirth》2011,11(1):1-19
Background
Rates of labour induction are increasing. We conducted this systematic review to assess the evidence supporting use of each method of labour induction.Methods
We listed methods of labour induction then reviewed the evidence supporting each. We searched MEDLINE and the Cochrane Library between 1980 and November 2010 using multiple terms and combinations, including labor, induced/or induction of labor, prostaglandin or prostaglandins, misoprostol, Cytotec, 16,16,-dimethylprostaglandin E2 or E2, dinoprostone; Prepidil, Cervidil, Dinoprost, Carboprost or hemabate; prostin, oxytocin, misoprostol, membrane sweeping or membrane stripping, amniotomy, balloon catheter or Foley catheter, hygroscopic dilators, laminaria, dilapan, saline injection, nipple stimulation, intercourse, acupuncture, castor oil, herbs. We performed a best evidence review of the literature supporting each method. We identified 2048 abstracts and reviewed 283 full text articles. We preferentially included high quality systematic reviews or large randomised trials. Where no such studies existed, we included the best evidence available from smaller randomised or quasi-randomised trials.Results
We included 46 full text articles. We assigned a quality rating to each included article and a strength of evidence rating to each body of literature. Prostaglandin E2 (PGE2) and vaginal misoprostol were more effective than oxytocin in bringing about vaginal delivery within 24 hours but were associated with more uterine hyperstimulation. Mechanical methods reduced uterine hyperstimulation compared with PGE2 and misoprostol, but increased maternal and neonatal infectious morbidity compared with other methods. Membrane sweeping reduced post-term gestations. Most included studies were too small to evaluate risk for rare adverse outcomes.Conclusions
Research is needed to determine benefits and harms of many induction methods. 相似文献2.
Kalampokas E Sofoudis C Antonogeorgos G Panoulis K Aravantinos L Grigoriou O Kalampokas T 《Archives of gynecology and obstetrics》2012,286(4):853-857
Purpose
To evaluate the efficacy of misoprostol administrated vaginally on cervical priming and its complications prior to diagnostic or operative hysteroscopy in women who have undergone at least one cesarean section and who have never delivered vaginally before and/or had other transcervical procedure.Methods
A total of 55 patients undergoing hysteroscopy for various intra-uterine lesions were included in this study and were randomly allocated to two groups finally. Thirty patients in the study group were given 200?μg misoprostol vaginally 12?h before the procedure, whereas 25 patients in the control group did not receive any cervical priming. The countered outcome included the cervical width detected with Hegar dilatators and complication rates.Results
Mean cervical width was greater in the study group (6.6?±?1.3) than in the control group (5.1?±?0.9). Complications and failure rates were lower in the study group.Conclusion
Application of 200?μg misoprostol vaginally 12?h before hysteroscopy softens the cervix, reduces cervical resistance and consequently the need for cervical dilatation, with only mild side effects. 相似文献3.
Purpose
To compare induction-to-delivery intervals of Foley catheters and double balloon catheters in second trimester pregnancy terminations.Methods
This randomized parallel study was conducted on women who underwent second trimester terminations between December 2016 and December 2017. Pregnant women in the second trimester with a Bishop score?<?6 were included in the study. Participants were randomized into two groups, the first being the Foley catheter group and the second being the double balloon catheter group. The time frames from insertion of catheters to the delivery were recorded in each group. A multiple regression analysis was carried out to examine the contribution of factors to the induction-to-delivery interval. A survival analysis was conducted to compare the Foley method and the double balloon method.Results
A total of 91 pregnant women were included in the final analysis. The induction-to-delivery interval was shorter in the Foley catheter group than in the double balloon catheter group (38 h 54 min?±?21 h 6 min versus 58 h 17 min?±?25 h 56 min). We also found that women with intrauterine fetal death (IUFD) had a shorter time to delivery compared to women with live fetuses (39 h 12 min?±?18 h 46 min vs 51 h 30 min?±?26 h 42 min, p?=?0.04). Women with a history of vaginal delivery also had a shorter induction-to-delivery time compared to women who never delivered vaginally before (38 h 12 min?±?17 h 42 min vs 53 h 54 min?±?27 h 18 min, p?=?0.004). In the multiple regression analysis, the most significant contributor to the induction-to-delivery time was the method used for induction of labor and followed by other factors including the viability of the fetus (live/IUFD), history of vaginal delivery and PPROM. The survival analysis showed that the induction-to-delivery interval was significantly shorter in the Foley catheter group than in the double balloon catheter group (HR 2.51, 95% CI 1.57–4.00, p?=?0.001).Conclusion
During the termination of second trimester pregnancies time from induction of labor to delivery is shorter with the Foley catheter compared to double balloon catheter.4.
Ibrahim Abd Elgafor El Sharkwy Elsayed Hamdy Noureldin Ekramy Abd Elmoneim Mohamed Sherine Attia Shazly 《Journal of obstetrics and gynaecology of India》2018,68(5):408-413
Background
To compare between the sequential and concurrent use of vaginal misoprostol plus Foley catheter for labor induction.Methods
This single-center, non-blinded randomized study was conducted at the department of Obstetrics and Gynecology, Faculty of medicine, Zagazig University. A total of 160 women with full term singleton pregnancy, cephalic presentation and bishop score ≤ 6 were randomized for labor induction with either concurrent or sequential use of vaginal misoprostol plus Foley catheter (80 cases in each group). The primary outcome measured was induction-to-delivery interval and secondary outcomes mesaured were vaginal delivery within 24 h, number of doses needed to induce labor, need of oxytocin for augmentation of labor, cesarean section rate, maternal or neonatal complications.Results
The mean induction-to-delivery interval was 22.33 ± 13.28 h versus 18.45 ± 14.34 h (p = 0.041) in sequential and concurrent group, respectively. The percentage of women who completed vaginal delivery within 24 h was 51% versus 61% (p = 0.046) in sequential and concurrent group, respectively. Other maternal and neonatal outcomes were similar in both groupsConclusion
Concurrent use of vaginal misoprostol plus Foley catheter for labor induction was associated with shorter induction-to delivery interval compared to sequential use, and it increases the rate of vaginal delivery in the first 24 h.5.
Objectives
To compare oral misopostol 600 mcg with 10 IU units oxytocin i.m. in the active management of the third stage of labor.Materials and Methods
A total of 200 pregnant women of 34–42 weeks of gestation delivering vaginally in the Rajendra Institute of Medical Sciences, Ranchi, were selected for study. Hundred women received oral misoprostol 600 mg and 100 women received i.m. oxytocin 10 IU immediately after delivery of the baby and cord clamping by the method of randomization.Results
In the misoprostol group, mean blood loss is 145 ml, mean duration of the third stage of labor is 3.76 min, and mean fall in hemoglobin is 0.55 g/dl. In the oxytocin group, mean blood loss in 125.6 ml, mean duration of the third stage of labor in 3.50 min, and mean fall in hemoglobin is 0.48 g/dl. There was no significant difference between the two groups with regard to the above-mentioned factors. There were 8 cases of PPH in the misoprostol group and 6 cases in the oxytocin group. Twenty-two cases in the misoprostol group and 16 cases in the oxytocin group required additional oxytocics. Adverse effects like shivering and pyrexia were more in the misoprostol group.Conclusion
Oral misoprostol is as effective as oxytocin in AMTSL and can be used safely in vaginal deliveries for prevention of PPH, especially in non-institutional deliveries and in places of low resource settings. 相似文献6.
Megha Sharma Parneet Kaur Khushpreet Kaur Arvinder Kaur Preet Kanwal Kaur Mohi Manjit Kaur 《Journal of obstetrics and gynaecology of India》2014,64(3):175-179
Objectives
To study oxytocin, misoprostol, and methylergometrine in active management of the third stage of labor and determine duration of the third stage of labor, blood loss, adverse effects, and need for additional uterotonics in each group.Methods
Clinical trial of 300 women with healthy singleton pregnancy allocated into three groups to receive either: 10 IU intravenous oxytocin infusion, 600 μg sublingual misoprostol, or 200 μg intravenous methylergometrine. Primary outcome measure was blood loss in the third stage of labor; secondary measures were duration of the third stage, side effects, and complications.Results
Subjects who received 600 μg of misoprostol had the least blood loss, followed by oxytocin, and methylergometrine. The shortest mean duration of the third stage was with misoprostol. Shivering and pyrexia were observed in misoprostol group, and raised blood pressure in methylergometrine group.Conclusions
Misoprostol is as effective as oxytocin and both are more effective than methylergometrine in active management of the third stage of labor. 相似文献7.
Waleed El-Khayat Heba Alelaiw Abdallah El-kateb Ali Elsemary 《The journal of maternal-fetal & neonatal medicine》2016,29(3):487-492
Objective(S): To compare the effectiveness and safety of intra-cervical Foley catheter combined with intra-vaginal isosorbide mononitrate (IMN) versus intra-vaginal misoprostol for cervical ripening and labor induction in pregnant women with unripe cervices.Methods: Open-labeled randomized controlled trial in Cairo university hospital, Cairo, Egypt during 2012–2014. Three hundred and ninety-five pregnant women at term or post-term with an indication for labor induction and unripe cervix were included in the study. The subjects were randomly divided into two groups. Vaginal misoprostol was used in group 1 (n?=?197) and intra-cervical Foley catheter plus vaginal IMN in group 2 (n?=?198). Our main outcome measure was cesarean section rate.Results: Among the 395 included patients there were significantly lower duration of induction of labor (p?<?0.001) in group 1with lower cesarean section rates [22.8% in group 1versus 33.3% in group 2; RR 0.7 (0.6–0.9), (p?=?0.020)]. Whereas the uterine hyperstimulation (p?<?0.001) was significantly higher in group 1. There were no significant differences between both groups as regard patients’ demographic characteristics.Conclusions(s): Vaginal misoprostol is more effective but less safe than Foley catheter combined with vaginal IMN for induction of labor in term and post-term pregnancy. 相似文献
8.
Mohamed Abd-Allah Rezk Zakaria Sanad Ragab Dawood Mohamed Emarh Alaa Masood 《The journal of maternal-fetal & neonatal medicine》2015,28(1):93-96
Objectives: To examine the effectiveness, safety and acceptability of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy.Methods: This clinical study was conducted on 90 pregnant patients intended for termination of pregnancy between 13 and 24 gestational weeks for any indication. Enrolled women are equally allocated into three groups:??Group I (Misoprostol group): a standard regimen of moistened misoprostol (400?μg) 4 hourly inserted vaginally.??Group II (Catheter group): intracervical Foley catheter inserted, inflated and placed on traction.??Group III (Combined group): intracervical Foley catheter inserted with a standard regimen of moistened misoprostol (400?μg) 4 hourly intravaginally was used.Procedure efficacy (defined as complete abortion performed on site), safety and acceptability were assessed.Results: The induction to abortion interval was 7.5?±?1.25?h in the combined group, compared to 11.76?±?1.63?h in the misoprostol group and 19.76?±?1.52?h in the catheter group (p value?0.001) with a success rate of 100% and no major complications reported.Conclusions: The present results confirmed the high success rate with the shortest induction to abortion interval with a combined use of intracervical Foley catheter and misoprostol for termination of second trimester pregnancy. 相似文献
9.
Culver J Strauss RA Brody S Dorman K Timlin S McMahon MJ 《American journal of perinatology》2004,21(3):139-146
The objective of this study was to compare the efficacy and safety of intracervical Foley catheter with concurrent use of oxytocin versus vaginal misoprostol for labor induction in nulliparous women. Nulliparous women with Bishop score <6 who presented for labor induction were randomized to either 25 microg vaginal misoprostol every 4 hours followed by oxytocin, if indicated, or intracervical Foley catheter with simultaneous use of oxytocin. Among the 162 patients enrolled, 79 (49%) received misoprostol and 83 (51%) received Foley/oxytocin. We were unable to demonstrate a statistically significant difference between the misoprostol group and Foley/oxytocin group in the incidence of cesarean delivery (35% versus 29%; p = 0.37). The induction-to-delivery time was significantly shorter in the Foley/oxytocin group (18 versus 24 hours; p < 0.01). No differences in intrapartum complications, neonatal outcomes, or maternal morbidity were found. When compared with vaginal misoprostol, intracervical Foley catheter combined with oxytocin has a similar efficacy and safety profile for labor induction in nulliparous women. Foley/oxytocin results in a shorter induction-to-vaginal delivery time compared with misoprostol. 相似文献
10.
Kruchkovich J Orvieto R Fytlovich S Lavie O Anteby EY Gemer O 《Archives of gynecology and obstetrics》2012,286(1):135-137
Objective
To evaluate the ability of Creatine phosphokinase (CPK) levels and CPK-MB proportion to differentiate between extra and intrauterine of very early gestations with unknown location.Materials and methods
The study is case?Ccontrol. CPK levels and CPK-MB proportion in 51 women with extrauterine pregnancies were compared to those in 28 women with early intrauterine pregnancies.Results
No significant difference was found between women with extrauterine pregnancies and early intrauterine pregnancies in the levels of CPK (80.9?±?62.1 vs. 74.9?±?51.5; p?=?0.66) and CPK-MB proportion (16.2?±?10.1% vs. 15.1?±?11.1%; p?=?0.86).Conclusion
CPK and CPK-MB proportion determinations do not contribute to the clinical differentiation between early intra and extrauterine pregnancies. 相似文献11.
Mullin PM House M Paul RH Wing DA 《American journal of obstetrics and gynecology》2002,187(4):847-852
OBJECTIVE: The purpose of this study was to compare intravaginal misoprostol with extra-amniotic saline solution infusion with concomitant oxytocin for cervical ripening and labor induction in viable pregnancies. STUDY DESIGN: Two hundred women with indications for labor induction and unfavorable cervices were assigned randomly to vaginal misoprostol or extra-amniotic saline solution infusion. Twenty-five micrograms of misoprostol was administered every 4 hours up to six doses, followed by intravenous oxytocin administration. Patients who had received extra-amniotic saline solution infusion also received intravenous oxytocin along with a maximum 12-hour saline solution infusion through Foley catheters that were placed above the internal cervical os. RESULTS: One hundred women were randomly assigned to misoprostol, and 100 women were assigned randomly to extra-amniotic saline solution infusion. The average interval from start of induction to vaginal delivery was longer in the misoprostol group (1323.3 +/- 700.3 minutes) than in the extra-amniotic saline solution infusion group (970.4 +/- 502.7 minutes; P =.006, log transformed data). Abnormal fetal heart rate tracings were found in 30% of the patients who received misoprostol and in 19% of the patients who received extra-amniotic saline solution infusion (relative risk, 1.6; 95% CI, 1.0-2.4; P =.05). There was more tachysystole in the misoprostol group (8%) than in the extra-amniotic saline solution infusion group (1%; P =.02). There were no differences in the routes of deliveries or neonatal outcomes between groups. CONCLUSION: Extra-amniotic saline solution infusion with oxytocin administration appears more effective and is associated with fewer maternal complications than misoprostol for cervical ripening and labor induction. 相似文献
12.
Renu Tewatia Shikha Rani Usha Srivastav Bela Makhija 《Archives of gynecology and obstetrics》2014,289(4):739-742
Background
Post-partum hemorrhage (PPH) is the most common direct cause of maternal mortality and timely intervention can save many lives.Objective
To compare the effectiveness of sublingual misoprostol to intravenous oxytocin in preventing post-partum hemorrhage in low risk vaginal birth.Methods
One hundred patients with no risk factor for PPH were randomly allocated to receive 600 μg misoprostol administered sublingually or 10 IU of intravenous oxytocin immediately after the delivery of baby. Main outcome measures were post-partum blood loss, drop in hemoglobin in 24 h, duration of third stage of labor, and drug-related adverse effects.Results
Mean age, parity and gestational age were similar in both groups. Mean blood loss was significantly lower in oxytocin group (114.28 ± 26.75 versus 149.50 ± 30.78 ml; p = 0.00). Drop in hemoglobin was 0.31 ± 0.16 versus 0.49 ± 0.21 g% (p = 0.01) in oxytocin and misoprostol group, respectively. Duration of third stage labor was shorter in oxytocin group (median 5 min, IQR: 4.5–5.5 versus 5.5 min, IQR: 5–6 min, p < 0.01). Although fever and shivering were common adverse effects with misoprostol but were not clinically significant.Conclusion
Intravenous oxytocin is more efficacious than sublingual misoprostol in preventing PPH in institutional deliveries. 相似文献13.
Ibrahim Abd Elgafor el Sharkwy 《Archives of gynecology and obstetrics》2013,288(6):1231-1236
Objectives
To compare combined sublingual misoprostol plus oxytocin infusion with intravenous carbetocin for prevention of postpartum hemorrhage (PPH) in patients with risk factors during cesarean section (CS).Methods
In this randomized study, 380 patients were randomly allocated to receive either combined 400 μg sublingual misoprostol before surgery plus 20 IU oxytocin after delivery of baby (n = 190) or intravenous 100 μg carbetocin (n = 190). The main outcome measure was requirement of additional pharmacological uterotonic. Secondary outcomes were the difference in preoperative and postoperative hemoglobin, estimated blood loss, incidence of blood transfusion and adverse effects.Results
16.3 % of women who received sublingual misoprostol plus oxytocin infusion required additional uterotonic versus 13.7 % of women who received intravenous carbetocin with no significant difference (p = 0.27). No significant difference between treatment groups in preoperative and postoperative hemoglobin level change, estimated blood loss, incidence of blood transfusion was observed. Shivering and fever were significantly higher with misoprostol plus oxytocin (p = <0.001 and <0.001, respectively).Conclusion
Both sublingual misoprostol plus oxytocin infusion and intravenous carbetocin are similarly effective for the prevention of PPH in patients with risk factors during CS. 相似文献14.
Caliskan E Dilbaz S Gelisen O Dilbaz B Ozturk N Haberal A 《The Australian & New Zealand journal of obstetrics & gynaecology》2004,44(6):562-567
BACKGROUND: Misoprostol fails to induce labour in 5-20% of women at term. AIM: To analyse possible predictors of unsuccessful induction with 50 microg vaginal misoprostol and effectiveness and the safety of intracervical Foley catheter application in induction failures. METHODS: An observational study was conducted on 1030 women with singleton, live fetuses, vertex presentation, > 34 weeks of gestation and Bishop score < 5. Induction of labour with 50 microg vaginal misoprostol repeated every 6 h was attempted. Women without regular uterine contractions and cervical changes at the end of 24 h were considered to be unsuccessful, and a transcervical Foley balloon catheter was placed and inflated with 50 mL saline. Possible predictors of induction failures were analysed via logistic regression analysis. Neonatal outcomes and vaginal delivery achieved after Foley catheter were also determined. RESULTS: Induction was successful in 918 cases (89.1%) and Foley catheter was placed in 112 (10.8%) women. Increasing gestational age in weeks (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.68-0.88) and increasing Bishop score (OR 0.73, 95% CI 0.60-0.90) decreased the risk of failed induction. Failure rates were 16% (27/169) in post-term nulliparous women with Bishop score = 1 and 40% (4/10) in preterm women with Bishop score = 1. Foley catheter achieved vaginal delivery in 83% of these women without causing an increase in the adverse neonatal outcomes. CONCLUSION: When misoprostol induction fails, Foley catheter is a safe and effective method for cervical ripening. Foley catheter can be the first treatment of choice in post-term nulliparous women or preterm women with Bishop score = 1. 相似文献
15.
Purpose
The commonest surgical procedure for women is cesarean delivery. Postpartum hemorrhage and intra-operative blood during cesarean delivery is a major concern to all obstetricians. This study was conducted to assess the efficacy of the adjuvant use of misoprostol and oxytocin in decreasing intra-operative blood loss in cesarean delivery.Methods
This was a double-blinded randomized clinical trial including 636 term pregnant woman scheduled for cesarean section at Ain Shams University Maternity Hospital, Cairo, Egypt, between February 2013 and February 2014. Participants received either 400-μg misoprostol rectally or sublingually or placebo before cesarean section together with 5-IU oxytocin IV. The main outcome measure was intra-operative blood loss. Difference between the three groups was analyzed using one-way ANOVA test (for numeric variables) and Chi-square test (for categorical variables). P?<?0.05 was considered statistically significant.Results
Intra-operative blood loss was higher in patients who did not receive misoprostol (Placebo Group) (295–1075 ml, 641.7?±?135.7) than those who received it, regardless the route of administration, rectal (135–830 ml, 457.5?±?140.7; P?<?0.001), and sublingual (135–680 ml, 357.8?±?129.7; P?<?0.001). In addition, sublingual route was associated with significantly lower estimated intra-operative blood loss compared to rectal administration (P?<?0.001).Conclusions
Misoprostol with oxytocin is an effective drug-combination for decreasing intra-operative blood loss during cesarian section with clinical superiority to sublingual over rectal route.16.
Objective
To test the hypothesis that there is a higher rate of unsuccessful induction of labor (IOL) in post-term obese pregnant women compared to non-obese ones.Methods
In this prospective cohort study, 144 obese (BMI?>?30) and 144 non-obese (BMI?<?29.9) post-term (>?41 weeks) pregnant women were recruited. IOL was done by misoprostol or amniotomy and oxytocin infusion according to the Bishop score. Comparison of percentage of failed IOL in both groups (primary outcome) was performed by the Chi-test. Logistic regression and multivariable regression were performed to assess the odds ratio (OR) of cesarean section (CS) and coefficient of delay in labor till vaginal delivery (VD) in obese versus (vs) non-obese groups. Adjustment for gestational age, parity, Bishop Score, membrane rupture and amniotic fluid index was done in both regression analyses.Results
CS rate was significantly higher in obese group [26.4 vs 15.9%; difference in proportion (95% CI) 0.1 (0.01, 0.19); P value 0.02]. 106 (73.6%) obese women and 121 (84.1%) non-obese women delivered vaginally. In addition, the duration till VD was significantly higher in obese group (22 vs 19 h, P value 0.01). After adjustment for possible confounding factors, the CS was still higher in the obese group in comparison to non-obese group (OR 2.02; 95% CI 1.1, 3.7; P value 0.02). This finding suggested that obesity was an independent factor for failure of IOL. In addition, after adjustment for these confounders, obesity had the risk of increasing labor duration by 2.3 h (95% CI 0.1, 4.5) in cases that ended in VD.Conclusion
Based on our results, we conclude that there is a higher risk of CS in obese postdate pregnant women undergoing IOL in comparison to non-obese counterparts. Therefore, obstetricians should pay more attention to advising pregnant women about optimal weight gain during pregnancy and counseling about the chances of VD in cases of IOL.ClincalTrial.gov ID
NCT02788305.17.
H. Guler Sahin Ali Kolusari Mansur Kamaci Canev Kaynak Hatice Tuncel 《Archives of gynecology and obstetrics》2009,280(6):889-892
Purpose
To investigate the association of neonatal bilirubin levels with oxytocin and misoprostol use for labour induction.Methods
A total of 100 neonates were included in the study. The first group consisted of 50 healthy babies of women who had received oxytocin infusion, and the second group consisted of 50 healthy babies of women who had received 25 μg misoprostol every 4 h placed in the posterior fornix for labour induction. Bilirubin and haematocrit levels were measured in all on days 1 and 4 of the neonatal period.Results
The levels of bilirubin in the oxytocin group were significantly higher than those in the misoprostol group on day 1 [4.42 ± 0.27 vs. 3.55 ± 0.28 mg/dl (P = 0.035)] while they were higher also on day 4 but not significantly so [7.47 ± 0.63 vs. 6.86 ± 0.65 mg/dl (P = 0.525)]. The mean haematocrit levels on day 1 were 50.62 ± 1.23 and 58.04 ± 1.30 in groups 1 and 2, respectively, with a significant difference between them. The levels were 52.31 ± 1.27 and 58.96 ± 1.14 on day 4 and the difference was again significant. P < 0.05 indicated statistical significance.Conclusions
Labour induction with misoprostol and oxytocin does not seem to have harmful effects on bilirubin levels in the neonate. 相似文献18.
Objective
To compare oral mifepristone (400 mg) with trans-cervical balloon catheter for induction of labor (IOL) in post date women with previous one cesarean section (CS).Methods
In this randomized trial, post date pregnant women (gestation 40 weeks 5 days), with previous one low segment CS (no previous vaginal delivery) were induced either with oral mifepristone (400 mg) or balloon catheter [Foley’s catheter (16 Fr); bulb filled with 30 ml normal saline]. They were re-assessed 24 and 48 h later. If at any time Bishop Score was >6; amniotomy was done, followed by oxytocin infusion. Primary outcome of the study was labor onset after first manoeuvre. Secondary outcomes were cervical ripening, need of oxytocin, vaginal delivery and CS, in two groups.Results
From June 2012 to September 2015, we enrolled 107 women. Out of these, 57 received oral tablet mifepristone (400 mg) and 50 were inserted with balloon catheter. Labor onset after first manoeuvre was statistically significantly more in mifepristone group (37/57 vs. 13/50, respectively; p value 0.000). Bishop Score after 24 h was better in balloon catheter (p value 0.000). More women with balloon catheter required oxytocin for IOL (37/50 vs. 20/57, respectively; p value 0.000) along with higher dose [840 (320) mU vs 560 (120) mU, respectively, p value 0.000]. Failure of induction was statistically significantly higher in balloon catheter group (8 out of 50 vs. 2 out of 57, respectively, p value 0.043). There was no statistically significant difference in normal delivery or CS in either group (p value 0.242 and 0.331, respectively).Conclusion
Oral mifepristone (400 mg) is associated with statistically significantly higher incidence of labor onset in post date pregnant women with previous one CS, as compared to balloon catheter. Both methods are primarily for cervical ripening and oxytocin should not be delayed in the absence of onset of labor.Clinical Trial Registration
Clinical Trials Registry-India, www.ctri.nic.in, CTRI/2012/05/003634.19.
Haydardedeoglu B Kilicdag EB Parlakgumus AH Zeyneloglu HB 《Archives of gynecology and obstetrics》2012,286(3):763-769
Objective
To compare the IVF/ICSI outcomes of the long GnRH agonist and the fixed GnRH antagonist protocol in women with PCOS.Design
Randomized controlled trial.Setting
Baskent University Department of Obstetrics and Gynecology.Patients
Three hundred women with PCOS.Interventions
IVF/ICSI following the long GnRH agonist down-regulation or the fixed GnRH antagonist protocols.Main outcome measures
Ongoing pregnancy rates.Results
Ongoing pregnancy rates were 36.4?% in the OCP?+?GnRH agonist group and 35.9?% in the OCP?+?GnRH antagonist group (p?>?0.05). Progesterone levels on the day of hCG (0.76?±?0.71 vs. 0.58?±?0.50), endometrial thickness on the day of hCG (11.57?±?2.50 vs. 10.50?±?2.01), total gonadotropin used (1388.71?±?482.39 vs. 1253.25?±?415.81), and duration of COH (9.07?±?1.96 vs. 8.39?±?1.75) were significantly lower in the OCP?+?GnRH antagonist group.Conclusion
The OCP?+?long GnRH agonist and the OCP?+?fixed GnRH antagonist protocols yield similar ongoing pregnancy rates in women with PCOS. Although this study consisting three hundred patients, seems to be large enough in a single center, we were not able to reach to the actual size of power analysis which was approximately 3,000. 相似文献20.
Fateme Davari Tanha Tahmineh Golgachi Nasrin Niroomand Mahsa Ghajarzadeh Reza Nasr 《Archives of gynecology and obstetrics》2013,287(1):65-69