宫颈扩张球囊用于足月妊娠促宫颈成熟及引产的临床研究

Clinical Study of Cervical Dilatation Balloon Used in Full-term Pregnancy to Promote Cervical Ripening and Induce Labor

目的探讨足月妊娠促宫颈成熟和引产中宫颈扩张球囊的有效价值。方法纳入该院2018年1月—2020年1月接收有引产指征的初产妇60例,以信封随机化分组模式分为研究组和对照组,每组30例。对照组单用缩宫素处理,研究组在上述基础上加行宫颈扩张球囊+人工破膜。记录两组促宫颈成熟效果、引产效果和分娩形式、不良影响。结果研究组促宫颈成熟有效率93.33%高于对照组60.00%,组间对比差异有统计学意义(χ^(2)=9.317,P=0.002);研究组中有4例放置Cook球囊后存在下腹部不适反应,经过休息后有所改善。分娩结局分析,两组产后出血、胎儿窘迫、产褥感染、新生儿窒息比较,差异无统计学意义(P>0.05)。干预前对照组Bishop分值(2.15±0.81)分与研究组(2.26±0.74)分对比差异无统计学意义(t=0.549,P=0.585);干预后6 h,研究组(6.30±1.33)分高于对照组(4.59±1.10)分,且干预后12 h,研究组(7.99±1.60)分高于对照组(6.76±1.56)分,组间对比差异有统计学意义(t=5.427、3.015,P<0.05)。结论宫颈扩张球囊用于足月妊娠促宫颈成熟及引产中,能够降低剖宫产率,同时不良影响小,是一种十分安全可行的引产方式。

Objective To explore the effective value of cervical dilatation balloon in full-term pregnancy in promoting cervical ripening and inducing labor.Methods Sixty primiparas with indications for induction of labor received by the hospital between January 2018 and January 2020 were included.They were divided into a study group and a control group by the envelope randomization grouping pattern,with 30 cases in each group.The control group was treated with oxytocin alone,and the study group received cervical dilatation balloon+artificial rupture of the membrane on the basis of the above.The effect of promoting cervical ripening,the effect of induction of labor,the form of delivery,and the adverse effects of the two groups were recorded.Results The effective rate of cervical ripening in the study group was 93.33%higher than 60.00%in the control group.The difference between the groups was statistically significant(χ^(2)=9.317,P=0.002);4 cases in the study group had lower abdominal discomfort after the Cook balloon was placed.Improved after a rest.In the analysis of delivery outcomes,there was no statistically significant difference between the two groups of postpartum hemorrhage,fetal distress,puerperal infection,and neonatal asphyxia(P>0.05).Ther was no statistically significant differences between the Bishop scores of the control group(2.15±0.81)points and the study group(2.26±0.74)points before the intervention(t=0.549,P=0.585);6 h after the intervention,the study group(6.30±1.33)points was higher than that of the control group(4.59±1.10)points,and 12 hours after the intervention,the score of the study group(7.99±1.60)points was higher than that of the control group(6.76±1.56)points.The difference between the groups was statistically significant(t=5.427,3.015,P<0.05).Conclusion Cervical dilatation balloon used in full-term pregnancy to promote cervical ripening and induction of labor can reduce the rate of cesarean section,and at the same time,it has little adverse effect.It is a very safe and feasible way to induce labor.