摘要
Objective: Our purpose was to compare the efficacy and safety of two standardized preparations of prostaglandin E2, Prepidil and Cervidil, for ripening of the cervix and initiation of labor. Study design: This was a prospective randomized study. Subjects in whom induction of labor was indicated were randomly assigned to receive either Prepidil (n = 36), an intracervical prostaglandin E2 gel, or Cervidil (n = 37), a controlled-release hydrogel pessary, as a cervical ripening agent. Inclusion criteria included (1) a Bishop score of ≤7, (2) a cervix 70%. Each agent was administered according to the manufacturer's recommendations. Results: There was no difference in Bishop scores between the two groups at the completion of the ripening process. The following mean times were shorter for the pessary group than for the gel group: (1) insertion of the ripening agent to vaginal delivery (20.6 vs 26.4 hours, p = 0.017), (2) time to achieve cervical ripening (11.1 vs 15.2 hours, p p = 0.019), and (4) hospital stay (3.7 vs 4.4 days, p = 0.03). Labor was initiated without the use of oxytocin in 24% of patients in the pessary group versus 3% of those in the gel group (p = 0.014). Conclusion: Both prostaglandin E2 agents are effective in achieving cervical ripening; however, the controlled-release pessary achieves ripening over a shorter time period. Furthermore, because time to achieve vaginal delivery and length of stay are shorter, the use of oxytocin is less frequent, and there is no increase in complications, the overall cost is expected to be less with the use of Cervidil as compared with Prepidil.
摘要译文
目的：比较前列腺素E2，Prepidil和Cervidil两种标准制剂在宫颈成熟和分娩方面的疗效和安全性。研究设计：这是一项前瞻性随机研究。引导分娩的受试者被随机分配接受Prepidil（n \x3d 36），宫颈前列腺素E2凝胶或Cervidil（n \x3d 37）（一种控释水凝胶阴道栓剂）作为宫颈成熟剂。纳入标准包括（1）主教评分≤7，（2）宫颈70％。根据制造商的建议施用每种药剂。结果：两组在成熟过程完成后的主教成绩没有差异。（1）将催熟剂插入阴道分娩（20.6比26.4小时，p \x3d 0.017），（2）达到宫颈成熟的时间（11.1 vs 15.2小时，p \x3d 0.019），和（4）住院时间（3.7 vs 4.4天，p \x3d 0.03）。在子宫托组24％的患者中使用催产素而不使用催产素，而在凝胶组中则为3％（p \x3d 0.014）。结论：前列腺素E2均能有效促进宫颈成熟;然而，控释子宫托在较短时间内成熟。此外，因为达到阴道分娩的时间和停留时间较短，使用催产素的频率较低，且并发症没有增加，与Prepidil相比，使用Cervidil的总体成本预计会降低。
Jacquelyn K. Chyu MD Howard T. Strassner MD. Prostaglandin E2 for cervical ripening: A randomized comparison of Cervidil versus Prepidil☆☆☆★[J]. American Journal of Obstetrics and Gynecology, 1997,177(3): 606-611