Eylem indüksiyonu: oksitosin ve dinoprostonun karşılaştırılması

Öz

Labor induction is one of the most frequent procedures in pregnant women. The optimal regimen for preinduction cervical ripening and labor induction is not established. The aim of the present study was to compare the efficacy and safety of vaginal dinoprostone and intravenous oxytocin administration for labor induction. The medical records of the patients who had induction of labor at Okmeydanı Teaching and Research Hospital, Department of Obstetrics and Gynecology from January 2010 to June 2011 were evaluated retrospectively. The first group (143 patients) received a single dose of sustained- released dinoprostone 10 mg, which was inserted high into the vaginal fornix. The second group (151 patients) received intravenous oxytocin (synpitan). Maternal and fetal outcomes were compared. There were no significant differences between the two groups for parity, birth weight, fetal gender and mode of delivery. 195 (66.3%) of patiens had vaginal delivery and 99 (33.7%) had cesarean delivery. The median time from start of induction of labor to vaginal birth was longer when a prostaglandin E2 was used for labor induction than it was when oxytocin was used (20.1 hours vs 16.1 hours) (p

Anahtar Kelimeler

• Cervical ripening; dinoprostone; labor induction; oxytocin.

Labor induction: comparison between oxytocin and dinoprostone

Öz

Eylem indüksiyonu gebelerde en sık uygulanan prosedürlerden birisidir. Servikal olgunlaşma ve eylem indüksiyonu için uygun tedavi rejimi tam olarak belirlenmemiştir. Çalışmamızın amacı, eylem indüksiyonu için kullanılan vajinal dinoproston ve intravenöz oksitosinin etkinlik ve güvenilirliğini karşılaştırmaktır. Ocak 2010-Haziran 2011 tarihleri arasında Okmeydanı Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği'nde eylem indüksiyonu yapılan 294 hastanın dosya kayıtları retrospektif olarak incelendi. Olgular iki gruba ayrıldı. Birinci gruptaki 143 hastaya; 10 miligram kontrollü salınımlı dinoposton posterior vaginal fornikse yerleştirildi. İkinci gruptaki 151 hastaya ise intravenöz oksitosin uygulandı. Maternal ve fetal sonuçlar karşılaştırmalı olarak incelendi. Her iki grup arasında parite, doğum kilosu, fetal cinsiyet ve doğum şekli açısından anlamlı fark saptanmamıştır. 195 (%66.3) hasta vajinal, 99 (%33.7) hasta ise sezaryen doğum yapmıştır. Çalışmamızda, indüksiyon başlangıcından vajinal doğuma kadar geçen süre oksitosin grubunda (16.1 saat) Dinoproston grubuna (20.1 saat) göre anlamlı olarak daha kısa bulundu. Çalışmamızda hiçbir grupta, uterin rüptür ve maternal kayıp izlenmedi. Her iki grup arasında yenidoğan yoğun bakım ihtiyacı, 1. ve 5. dakika Apgar skorları açısından istatistiksel olarak anlamlı fark saptanmadı. (p>0,05). Oksitosin güvenilir ve efektif ve maliyet-performansı uygun bir ajandır. Araştırmamıza gore, maliyet-performans uygun olmasada, FDA (Amerikan Gıda ve İlaç Dairesi) onaylı kontrollü salınımlı Dinoproston, eylem indüksiyonu için alternatif bir metottur.

Anahtar Kelimeler

• Dinoproston; eylem indüksiyonu; oksitosin; servikal olgunlaşma.

Kaynakça

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