Clinical study of low-dose misoprostol for labor induction with low-bishop-score pregnancy

doi:10.3877/cma.j.issn.1673-5250.2015.01.008

Objective

To study the curative effects and nursing effects of low-dose vaginal misoprostol for labor induction with low-Bishop-score (<6 score)pregnancy.

Methods

From April to October 2012, a total of 100 cases pregnant women who delivered in Chongzhou Maternal & Child Health Hospital were selected into this study. Their ages were 21-36 years old, with low-Bishop-score (<6 score). According to strategies of labor induction by a lottery, they were divided into misoprostol group (n=60, labor induction with low-dose vaginal misoprostol) and oxytocin group (n=40, labor induction with intravenous oxytocin). Effects of labor induction, safety, outcomes of newborn, vaginal delivery rate and quality of nursing satisfaction were statistically analyzed between two groups. The study protocol was approved by the Ethical Review Board of Investigation in Chongzhou Maternal & Child Health Hospital.Informed consent was obtained from each participate. There were no significant differences of age, gestational age, Bishop-score, and etc. between two groups (P>0.05).

Results

The successful rate of labor induction in misoprostol group was much higher than that in oxytocin group, and with significant differences (P<0.05). Duration from use of low-dose vaginal misoprostol/ intravenous of oxytocin, and the first stage of labor in misoprostol group were much shorter than those in oxytocin group, and with significant difference (P<0.05). Rate of satisfaction with nursing care in misoprostol group was much better than that in oxytocin group, and also with significant difference (P<0.05).

Conclusions

It is safe and effective for labor induction with low-dose vaginal misoprostol to low-Bishop-score pregnancy. Compared with intravenous oxytocin low-dose vaginal misprostol can increase the rate of vaginal delivery, and quality of satisfaction with nursing care is excellent.

Key words: Misoprostol, Cervical ripening, Low-Bishop-score, Natural childbirth, Patient satisfaction

表1 两组待产孕妇一般临床资料比较(±s)

Table 1 Comparison of general clinical data between two groups (±s)

组别	例数	年龄(岁)	孕龄(周)	Bishop宫颈成熟度评分值(分)
米索前列醇组	60	24.3±4.0	40.4±7.8	4.2±0.5
缩宫素组	40	24.2±4.1	40.2±1.4	4.4±0.6
t值	?	0.140	0.622	1.995
P值	?	>0.05	>0.05	>0.05

表1 两组待产孕妇一般临床资料比较(±s)

Table 1 Comparison of general clinical data between two groups (±s)

组别	例数	年龄(岁)	孕龄(周)	Bishop宫颈成熟度评分值(分)
米索前列醇组	60	24.3±4.0	40.4±7.8	4.2±0.5
缩宫素组	40	24.2±4.1	40.2±1.4	4.4±0.6
t值	?	0.140	0.622	1.995
P值	?	>0.05	>0.05	>0.05

表2 两组待产孕妇引产效果比较(±s)

Table 2 Comparison of effects of different labor induction strategies between two groups (±s)

组别	例数	引产成功率[例数(%)]	用药至宫缩发动时间(h)	第一产程时间(h)	第二产程时间(min)	产后2 h出血量(mL)
米索前列醇组	60	54(90.0)	5.2±2.6	6.4±2.5	33.2±20.8	245.8±64.5
缩宫素组	40	22(55.0)	11.9±8.6	11.9±8.6	39.4±30.6	295.9±72.3
χ²值/t值	?	16.118	4.845	4.736	1.207	3.611
P值	?	<0.05	<0.05	<0.05	>0.05	<0.05

表2 两组待产孕妇引产效果比较(±s)

Table 2 Comparison of effects of different labor induction strategies between two groups (±s)

组别	例数	引产成功率[例数(%)]	用药至宫缩发动时间(h)	第一产程时间(h)	第二产程时间(min)	产后2 h出血量(mL)
米索前列醇组	60	54(90.0)	5.2±2.6	6.4±2.5	33.2±20.8	245.8±64.5
缩宫素组	40	22(55.0)	11.9±8.6	11.9±8.6	39.4±30.6	295.9±72.3
χ²值/t值	?	16.118	4.845	4.736	1.207	3.611
P值	?	<0.05	<0.05	<0.05	>0.05	<0.05

表3 两组待产孕妇经阴道分娩率比较[例数(%)]

Table 3 Comparison of rate of vaginal delivery mode between two groups [case(%)]

组别	例数	经阴道分娩率
米索前列醇组	60	45(75.0)
缩宫素组	40	13(32.5)
χ²值	?	7.796
P值	?	0.000

表3 两组待产孕妇经阴道分娩率比较[例数(%)]

Table 3 Comparison of rate of vaginal delivery mode between two groups [case(%)]

组别	例数	经阴道分娩率
米索前列醇组	60	45(75.0)
缩宫素组	40	13(32.5)
χ²值	?	7.796
P值	?	0.000

表4 两组待产孕妇分娩新生儿情况比较(±s)

Table 4 Comparison of incidence of meconium stained amniotic fluid, fetal distress, and Apgar scores in newborns between two groups (±s)

组别	例数	羊水浑浊发生率[例数(%)]	胎儿窘迫发生率[例数(%)]	Apgar评分(分)
米索前列醇组	60	27(47.4)	6(10.0)	9.28±0.84
缩宫素组	40	12(32.5)	5(12.5)	9.42±1.38
χ²值/t值	?	2.270	0.53	0.640
P值	?	0.132	0.695	>0.05

表4 两组待产孕妇分娩新生儿情况比较(±s)

Table 4 Comparison of incidence of meconium stained amniotic fluid, fetal distress, and Apgar scores in newborns between two groups (±s)

组别	例数	羊水浑浊发生率[例数(%)]	胎儿窘迫发生率[例数(%)]	Apgar评分(分)
米索前列醇组	60	27(47.4)	6(10.0)	9.28±0.84
缩宫素组	40	12(32.5)	5(12.5)	9.42±1.38
χ²值/t值	?	2.270	0.53	0.640
P值	?	0.132	0.695	>0.05

表5 米索前列醇组与缩宫素组患者对护理的满意率比较[例数(%)]

Table 5 Comparison of rate of patients satisfaction with nursing care between two groups [case(%)]

组别	例数	满意率
米索前列醇组	60	57(95.0)
缩宫素组	40	30(75.0)
χ²值	?	8.488
P值	?	0.004

表5 米索前列醇组与缩宫素组患者对护理的满意率比较[例数(%)]

Table 5 Comparison of rate of patients satisfaction with nursing care between two groups [case(%)]

组别	例数	满意率
米索前列醇组	60	57(95.0)
缩宫素组	40	30(75.0)
χ²值	?	8.488
P值	?	0.004

[1]	Akhter P, Sultana M, Hoque M, et al. Maternal outcome of prolonged pregnancy[J]. J Bangladesh College Phys Surg，2014, 32(2): 66–70.
[2]	王义，甄学慧，杨东梅，等. 产时胎儿监测在过期妊娠中的临床价值[J]. 中国妇幼保健，2013, 28(10): 1591–1593.
[3]	尹学琼. 米索前列醇用于低宫颈评分引产疗效及安全性分析[J]. 中国医药导报，2013, 10(22): 85–87.
[4]	Allen R, O'Brien BM. Uses of misoprostol in obstetrics and gynecology[J]. Rev Obstet Gynecol, 2009, 2(3): 159–163.
[5]	徐亚平. 产期综合护理干预在产妇分娩中的应用效果[J]. 实用临床医药杂志，2014, 18(8): 113–115.
[6]	李桂青，陈兰，赖少芳，等. 优质护理用于顺产产妇第四产程产后出血的效果评价[J]. 临床护理杂志，2012, 11(5): 15–17.
[7]	鲁泽春，周玲，杜建新，等. 宫颈Bishop评分与地诺前列酮计划分娩效果的临床观察[J]. 中国妇幼保健，2012, 27(22): 3405–3408.
[8]	Swamy GK. Current methods of labor induction; proceedings of the seminars in perinatology[M]. Dutch：Dutch Publishing Company Elsevier, 2012, 1–5.
[9]	Diven LC, Rochon ML, Gogle J, et al. Oxytocin discontinuation during active labor in women who undergo labor induction[J]. Am J Obstet Gynecol, 2012, 207(6): 471. e1-e8.
[10]	Durocher J, Blum J, Walraven G, et al. Misoprostol in the management of postpartum haemorrhage in low-resource settings[J]. BJOG, 2011, 118(9): 1144–1145.
[11]	赵桂萍. 助产士心理疲劳原因分析及对策[J]. 护理实践与研究，2010, 7(7): 106–107.
[12]	Jindal P, Avasthi K, Kaur M. A comparison of vaginal oral misoprostol for induction of labor-double blind randomized trial[J]. J Obstet Gynaecol India, 2011, 61(5): 538–542.
[13]	王增芳，王增艳，王萍萍，等. 网状Meta分析评估七种常用引产方法的效果及安全性[J]. 中华围产医学杂志，2014, 17(4): 230–236.
[14]	张玉红，孙国珍. 助产士职业压力的研究现状[J]. 全科护理，2014, 12(17): 1553–1554.
[15]	张晶. 小剂量米索前列醇用于足月妊娠促宫颈成熟的疗效观察[J]. 中国妇幼保健，2012, 27(20): 3174–3175.

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