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Am J Obstet Gynecol:诱导分娩:米索前列醇溶液每小时滴定剂量口服vs每2小时静态剂量口服

2017-05-17 吴星 环球医学

这些年已经积累了支持口服米索前列醇作为安全且廉价的药物用于诱导分娩的证据。2017年4月,发表在《Am J Obstet Gynecol》的一项由沙特阿拉伯科学家进行的研究,比较了每小时滴定和每2小时静口服米索前列醇溶液诱导生产的有效性和安全性。

这些年已经积累了支持口服米索前列醇作为安全且廉价的药物用于诱导分娩的证据。2017年4月,发表在《Am J Obstet Gynecol》的一项由沙特阿拉伯科学家进行的研究,比较了每小时滴定和每2小时静口服米索前列醇溶液诱导生产的有效性和安全性。

背景:米索前列醇是一种诱导分娩的有效药物。现有的指南推荐每2小时口服米索前列醇溶液25 μg。然而,需要更多研究以优化口服米索前列醇溶液用于诱导分娩。

目的:该研究的目的是比较每小时滴定剂量口服米索前列醇溶液与每2小时静态剂量口服米索前列醇溶液用于诱导分娩的有效性和安全性。

研究设计:在这项随机对照研究中,口服米索前列醇溶液按照(1)每小时20 μg(≤4剂),缺乏规律的子宫收缩时增加至每小时40 μg(≤4剂),然后增加至每小时60 μg(≤16剂),或每2小时25 μg直至开始积极生产(≤12剂)。计划样本量为146例女性,每小时滴定剂量米索前列醇溶液使用率达到95%,每2小时静态剂量米索前列醇溶液使用率达到80%为主要终点(24小时内阴道分娩)。安全结局包括母亲死亡率和新生儿不良结局。

结果:从2013年12月至2015年7月,146例女性被随机分配治疗。除了年龄以外,两组的人口特征和临床特征相似。47例(64.4%)使用每小时滴定剂量米索前列醇溶液的女性和48例(65.8%)使用每2小时静态剂量米索前列醇溶液的女性在24小时内成功实现阴道分娩(P=1.00)。未生育过的女性(P=1.00)或过期妊娠(P=0.66)、Bishop评分≤3(P=0.84)或催产素增加(P=0.83)的女性不同治疗组之间24小时内阴道分娩率没有显着差异。9例使用每小时滴定剂量米索前列醇溶液的女性和2例使用每2小时静态剂量米索前列醇溶液的女性在24小时内行剖宫产(P=0.056)。使用每小时滴定剂量米索前列醇溶液的女性发热和胎粪染色的发生频率更高。

结论:每2小时静态剂量口服米索前列醇溶液的有效性与每小时滴定剂量米索前列醇溶液相似,但副作用较少,并发症发生率更低。

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    2017-10-19 yhy100200
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    2017-05-19 linlin2312
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    2017-05-18 龙胆草

    学习了,谢谢分享

    0

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