不同容量小水囊对足月妊娠促宫颈成熟的临床观察

Clinical Observation of Different Capacity Small Water Balloons in Duced Labor Employed for Cervical Ripening in Term Pregnancy

目的:探讨并比较不同容量小水囊用于足月妊娠促宫颈成熟的临床效果。方法:选择足月妊娠、宫颈条件不成熟并要求引产孕妇180例,随机分为30 ml小水囊组、80 ml小水囊组及150 ml小水囊组,每组各60例。3组产妇分别采用充盈30 ml、80 ml、150 ml无菌0.9%氯化钠溶液的小水囊促宫颈成熟。比较3组产妇临床促宫颈成熟有效率、引产前后宫颈评分、分娩方式、引产至临产时间、第一产程时间、产后出血量、新生儿窒息率、新生儿体重及脐带脱垂率。结果:30 ml组、80 ml组、150 ml组产妇促宫颈成熟有效率分别为83.3%、95.0%、98.3%;80 ml和150 ml组产妇促宫颈成熟有效率、引产后宫颈评分、经阴道分娩率、引产至临产时间及第一产程时间均明显优于30 ml组产妇(P<0.05),但80 ml和150 ml组产妇促宫颈成熟有效率、引产后宫颈评分、经阴道分娩率、引产至临产时间及第一产程时间组间比较差异无统计学意义(P>0.05);3组产妇的产后出血量、新生儿窒息率及新生儿体重组间比较差异无统计学意义(P>0.05);30 ml和80 ml组产妇脐带脱垂率明显低于150 ml组(P<0.05),但30 ml组和80 ml组产妇脐带脱垂率组间比较差异无统计学意义(P>0.05)。结论:不同容量小水囊应用于足月妊娠促宫颈成熟均有确切效果,但80 ml小水囊促宫颈成熟效果显著,不易引起脐带脱垂,可作为临床首选方式加以应用。

Objective ：To evaluate and compare the clinical effectiveness of different capacity small water balloons induced labor employed for cervical ripening in term pregnancy. Methods.180 full-term pregnant women who had immature cervical conditions and required induction of labor were divided into 30 ml,80 ml and 150 ml groups randomly,60 cases in each group. Saline water balloons filled with 30 ml,80 ml and 150 ml were respectively used in the three groups of pregnancies to promote cervical ripening. The cervical repi ning efficiency, cervical Bishop score, mode of delivery, time of labor starting, time of first stage of labor, post partum hemorrhage,neonatal asphyxia rate, neonatal weight and umbilical cord prolapse rate were compared among the three groups. Results. The cervical repining efficiency of 30 ml, 80 ml, 150 ml groups were 83.3% ,95.0% ,98.3% respectively;the cervical repining efficiency,cervical score after induction of labor, vaginal delivery rate,time of labor starting and time of first stage of labor in both 80 ml and 150 ml groups were all significantly better than 30 ml group （ P 〈 0.05）, however, the cervical repining efficiency, cervical score after induction of labor,vaginal delivery rate,time of labor starting and time of first stage of labor be tween 80 ml and 150 ml group showed no significant difference （ P 〉 0. 05） ; the postpartum hemorrhage, neonatal asphyxia rate and neonatal weight among the three groups showed no significant difference （ P 〉 0.05） ~compared to the 150 ml group,the umbilical cord prolapse rate in both 30 m and 80 ml groups obviously decreased （ P 〈 O. 05）, but no significant difference was found between 30 ml and 80 ml groups in the umbilical cord prolapse rate （ P 〉0.05）. Conclusions：Different capacity small water balloons used in cervi cal ripening in term pregnancy has a definite effect. Moreover,the 80 ml water balloon is effective in cervical ripening in term pregnancy,and has a low risk of adverse reactions,which can be used as the clinically pre ferred way to apply.