子宫颈扩张球囊促宫颈成熟和引产的临床疗效

Observation of the clinical efficacy of cervical dilatation balloon for improving cervical ripening and induction of labor

目的:观察子宫颈扩张球囊用于促进妊娠晚期女性宫颈成熟和引产的临床疗效。方法:以2016年10月—2017年12月本院分娩的200例妊娠晚期足月孕妇为研究对象,按照随机数字表方法分为对照组(n=100)和观察组(n=100)。对照组予以小剂量缩宫素引产干预,观察组予以子宫颈扩张球囊引产干预。评估两组引产干预后的宫颈成熟度及分娩方式、妊娠结局和围产期并发症情况。结果:引产12h后,观察组Bishop评分(6.8±1.4分)高于对照组(5.5±1.4),宫颈成熟总体有效率(94.0%)高于对照组(77.0%),经阴道分娩率(82.0%)高于对照组(69.0%),第一产程、第二产程和总产程均短于对照组(均P<0.05);新生儿体重及新生儿窒息、产后出血和产褥期感染等围产期并发症发生率(9.0%)与对照组(10.0%)无统计学差异(P>0.05),两组引产过程中均未出现引产不耐受和胎盘早剥、宫颈破裂等引产不良反应。结论:较缩宫素引产,子宫颈扩张球囊技术可显著提高妊娠晚期女性宫颈成熟度,增加阴道分娩成功率,缩短产程,安全性较好,值得产科临床应用。

Objective： To observe the clinical efficacy of cervical dilatation balloon for promoting cervical ripening and induction of labor of later stage pregnant women. Methods： 200 full term pregnant women in Fuyang district maternity and child health care hospital from October 2016 to December 2017 were selected and were divided into control group （n=100） and study group （n=100） according to the random number table method. Women in control group were given small dose oxytocin for induced labor, and women in study group were given cervical dilatation balloon for induced labor. The cervical maturity condition of women was evaluated, and the mode of delivery, pregnancy outcomes, and the rate of perinatal complications were compared. Results： After 12h of induction, the Bishop score of women in study group （6.8±1.4 scores） was significant higher than that （5.5±1.4 scores） of women in control group （ P 〈0.05）. The total effective rate of improving cervical maturity （94.0%） of women in study group was significant higher than that （77.0%） of women in control group （ P 〈0.05）, and the rate of vaginal delivery （82.0%） in study group was significant higher than that （69.0%） of control group （ P 〈0.05）. The during of the first stage of labor, the second stage of labor and the total stage of labor of the women in study group were significant shorter than those of women in control group （ P 〈0.05）. There was no significant differeny in the incidence of perinatal complications of women between study group （9.0%） and control group （10.0%） （ P 〈0.05）. There was no any woman with adverse reactions, such as phenomena, placental abruption and cervical rupture in both groups. Conclusion： Compared with oxytocin induction of labor, cervical dilatation balloon can significantly improve cervical maturity of women with late pregnancy stage, can increase the success rate of vaginal delivery, and can shorten the time of labor, and has better safety, so it is worthy of clinical application.