Application of Vaginal Misoprostol Induction in Primiparas with Term PrelaborRupture of Membranes(PROM)
Objective To compare the efficacy and safety of vaginal misoprostol induction and oxytocin infusion induction in primip-aras with term premature rupture of membranes(PROM)and unfavorable cervixes.Methods A total of 506 primiparas with PROM who delivered in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2018 to December 2019 were retrospec-tively selected.All of the primiparas were with singleton cephalic presentation,reactive nonstress tests,2h≤PROM≤24h,cervical Bishop score＜6,and no previous uterine surgery.According to different methods of labor induction,the enrolled primiparas were divided into misoprostol group and oxytocin group.In the misoprostol group,misoprostol was placed vaginally to induce labor,and in the oxytocin group,oxytocin was intravenously injected to induce labor.The efficacy of induction,mode of delivery and m maternal and neonatal out-comes were compared between the two groups.Results The misoprostol group had more primiparas achieved the active phase than the ox-ytocin group(96.8％vs 89.1％,P=0.001).After 24h of induction,the misoprostol group showed a higher proportion of vaginal deliv-ery than the oxytocin group(60.6％vs 46.3％,P=0.001).The misoprostol group exhibited a significantly higher vaginal delivery rate and spontaneous vaginal delivery rate than the oxytocin group(87.1％vs 72.8％,P＜0.001;76.3％vs 64.2％,P=0.003).The ox-ytocin group had more primiparas who underwent cesarean section due to fetal distress(8.6％vs 3.6％,P=0.020)and failed labor in-duction(8.2％vs 1.6％,P=0.001)than the misoprostol group.The misoprostol group had a higher rate of uterine hyperstimulation than the oxytocin group(16.5％vs 9.7％,P=0.024).There were no significant differences in intrapartum chorioamnionitis,endome-tritis,postpartum hemorrhage,the incidence of neonatal asphyxia and admission to the neonatal intensive care unit between the two groups(P＞0.05).Conclusion Compared with oxytocin infusion,vaginal misoprostol induction in term PROM primiparas with unfavorable cervixes was associated with higher rates of cesarean and vaginal delivery within 24h.Vaginal misoprostol induction and oxytocin infusion had similar maternal and neonatal outcomes.
Term premature rupture of membranesParturition inductionCervical Bishop scoreMisoprostolOxytocinPrimipara
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