Clinical Study Of The Two Types Of Induced Labor On Early Onset Severe Preeclampsia

Objectives Early onset severe preeclampsia, getting early, seriously and with more complications, threatens maternal and child safety. Termination of pregnancy is the only effective measure. The study aims to discuss effectiveness and security of misoprostol and Foley catheter for labor induction.Methods 1 98 early onset severe preeclampsia cases, between 28~34 gestational weeks,had been collected in Tangshan maternal and service center from February 2014 to February 2016. 2 53 cases, who chose misoprostol, employed misoprostol for cervical mature, The pregnant women received 25 ug misoprostol which was placed in posterior fornix every time, then lay down 30 minutes. The total misoprostol was 50 ug at most per day, and dosing interval was not less than 6 hours, three days continuously. Once uterine contraction appeared, the misoprostol can not be used. According to the induced labor progress and cervical Bishop score, the obstetrician decide the use of oxytocin. 45 cases,who chose Foley catheter, used Foley catheter for cervical mature. The obstetrician put Foley catheter head between cervix and amniotic sac at 18:00 the first day, then injected40~60ml of 0.9% sterile sodium chloride solution into balloon catheter, at last put the Foley catheter end that was wrapped up in povidone-iodine gauze into vaginal. Then withdrew the Foley catheter and dripped oxytocin at 8:00 the second day. 3 The pregnant women, who chose vaginal delivery and went into maternity ward,were given epidural labor analgesia by anesthetist. 4 The pregnant women, who failed to delivery by vagina,had to adopt cesarean delivery.Results 1 The comparison of age, parity, body mass index, gestational age and blood pressure on admission, cervical bishop score before intervention between two groups had no significant difference(P>0.05). 2 The effect of maturing cervix, cervical bishop score after intervention, increased score, the time to uterine contraction, the time to parturiency and delivery between two methods had no statistical difference(P > 0.05). But the first stage of Foley catheter group was shorter than the misoprostol group(9.60±2.02 h vs 11.19±2.54h), the difference has statistical significance(P<0.05). 3 The comparison of vaginal delivery rate, cesarean section after failure of labor, episiotomy, forceps delivery rate,postpartum hemorrhage, postpartum fever, and the use of antihypertensive drugs in stage of labor, had no significant difference(P>0.05). But the oxytocin usage of Foley catheter group was obviously higher, but cervical laceration was lower than the misoprostol group(P < 0.05). 4 None of the patients and perineonate died in two groups. The comparison of abnormal fetal heart rate, the neonate admission to NICU, neonatal respiratory distress syndrome, neonatal apgar's score at 1 and 5 minute between twogroups had no significant difference(P>0.05).Conclusions 1 Both misoprostol and Foley catheter could used to terminate pregnancy for early onset severe preeclampsia patients. However, Foley catheter's time of first stage was shorter, cervical laceration rate was lower, but the oxytocin usage was obviously higher than the misoprostol. 2 Neither misoprostol nor Foley catheter, used for induced labor in patients with early onset severe preeclampsia, resulted in abnormal pregnant outcomes.