Results of using a combined method of cervical preparation for childbirth


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Objective. To optimize approaches to preparing the cervix uteri for childbirth in patients with the maternal passages being unprepared for labor. To comparatively evaluate the efficiency of a combined method for cervical preparation for childbirth with DILAPAN-S in combination with mifepristone, that of mechanical methods for cervical preparation with DILAPAN-S and a Foley catheter, as well as medical preparation of the cervix with prostaglandin E/PGE). Subjects and methods. The prospective comparative study enrolled 158 pregnant women aged 23 to 38 years (259-284 days of pregnancy). DILAPAN-S 4 was inserted for up to 12 hours in combination with mifepristone 200 mg twice at a 24-hour interval to prepare the cervix uteri for childbirth in 28 women (Group 1); the cervix uteri was prepared for childbirth, by inserting four DILAPAN-S dilators in 30 patients (Group 2); this was carried out, by inserting the balloon of a Foley catheter into the cervix for up to 12 hours in 50 patients (Group 3); the soft maternal passages were prepared for childbirth, by administering PGE2 gel 0.5 mg twice at a 6-hour interval in 50patients (Group 4). Results. The DILAPAN-S + mifepristone group displayed a mean Bishop score of 1.5, 2.14, and 1.9 higher than in the DILAPAN-S, Foley catheter, and PGE2 gel groups, respectively. In addition, the proportion of vaginal births was significantly higher in Group 1 than in the Foley catheter and PGE2 gel groups. The duration of labor differed in Groups 1-3, 2-3, and 3-4. Additional labor preinduction and induction were needed only in Groups 2, 3, and 4. Conclusion. The combined method of cervical preparation for childbirth with DILAPAN-S in combination with mifepristone of 200 mg twice is a more effective method than mechanical techniques, such as DILAPAN-S, a Foley catheter or medical preparation of the cervix with PGE2 gel.

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作者简介

Yevgeny Brega

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: e_brega@oparina4.ru
obstetrician-gynecologist

Galina Sakharova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: g_sakharova@oparina4.ru
Clinical resident

Oleg Pekarev

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: o_pekarev@oparina4.ru
MD, professor, deputy chief physician

参考

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