双球囊导管和地诺前列酮栓促宫颈成熟和引产效果比较研究

Effects of double balloon catheter and dinoprostone suppositories on maturing cervix and parturifacient action

目的比较宫颈扩张双球囊导管和地诺前列酮栓用于妊娠晚期促宫颈成熟的效果。方法回顾性分析足月妊娠、具有引产指征、宫颈Bishop评分≤5分的382例初产妇,其中球囊组200例和药物组182例,比较两组的促宫颈成熟效果及24 h内阴道分娩率,引产至阴道分娩所需时间。结果两组剖宫产率差异无统计学意义(25.5%vs 24.2%,P=0.67),药物组促宫颈成熟的效果高于球囊组(2.68±0.87 vs 2.44±0.74,P<0.01);药物组引产至阴道分娩时间低于球囊组[(17.13±2.56)h vs(19.86±2.96)h,P<0.01)];24 h内阴道分娩率两组无明显差别。结论两组引产方法均可提高宫颈不成熟孕妇阴道分娩率,对低评分宫颈不成熟的妊娠晚期患者,地诺前列酮栓促宫颈成熟效果优于双球囊导管。

Objective To compare the efficacy of double balloon catheter and dinoprostone suppositories on maturing cervix and parturifacient action. Methods A total of 382 full-term nulliparous women （200） cases in double balloon group and 182 cases in dinoprostone suppositories medicine group） with labour induction indications and unfavourable cervices （Bishop score≤5scores） were collected for retrospective analysis. The promoting effects of the two methods on cervical ripening, 24-hour vaginal delivery rates and inductiondelivery intervals were compared. Results There was no difference in ceasarean delivery rates between two groups （25.5% vs 24.2%, P=0.67）. Dinoprostone suppositories was more effective in promoting cervical ripening （2.68±0.87 vs 2.44±0.74, P〈0.01）. The induction-to-delivery interval was longer in the double balloon group （19.86±12.96）h than that in the medicine group（17.13±2.56）h （P〈0.01）. Conclusion Labour induction in nullipara with unfavourable cervices improve delivery rates. Dinoprostone suppositories is better than double balloon in promoting cervical ripening.