Comparative analysis of misoprostol regimens for cervical ripening in late pregnancy
Objective To analyze the effectiveness of misoprostol alone and in combination with oxytocin or a cervical balloon for cervical ripening in late pregnancy,to provide clinical treatment guidance.Methods Ninety patients requiring labor in-duction,admitted to the Department of Obstetrics of our hospital between May 2022 and May 2023,were randomly assigned to three groups of 30 each:Group A received misoprostol alone,Group B received misoprostol plus oxytocin,and Group C received misoprostol plus a cervical balloon.Cervical maturity was assessed using the Bishop score before medication,6 hours after medication,and 12 hours after medication.General induction outcomes were compared,including time from treatment start to labor onset,labor onset to delivery,and postpartum hemorrhage volume.Vaginal delivery rates,instru-mental delivery rates,cesarean section conversion rates,NICU admission rates,and adverse outcome rates were also com-pared.Newborn quality was evaluated using the 5-minute Apgar score.Results No significant differences were observed in Bishop scores before medication and 6 hours after medication among the three groups(P>0.05).Twelve hours after medi-cation,all three groups showed higher Bishop scores compared to pre-medication,with Group C having significantly higher scores than Groups A and B(P<0.05).Group C also had significantly shorter times from treatment start to labor onset and from labor onset to delivery compared to Groups A and B(P<0.05).Postpartum hemorrhage volumes were not signif-icantly different among the three groups(P>0.05).Group C had significantly higher vaginal delivery rates and lower ad-verse outcome rates compared to Group A(P<0.05).Both Groups B and C had significantly higher 5-minute Apgar scores than Group A(P<0.05),but no significant difference was found between Groups B and C(P>0.05).Conclusion The combination of misoprostol and a cervical balloon has higher comprehensive value for promoting cervical ripening and labor induction in late pregnancy,which can improve Bishop scores,vaginal delivery rates,and neonatal Apgar scores,and reduce adverse outcomes and labor process times.Clinical application is hence recommended.
MisoprostolOxytocinCervical balloonLate pregnancyCervical ripeningInduction of labor