口服米索前列醇与插Foley导尿管在促宫颈成熟中的应用

Application of oral misoprostol and intrauterine balloon in cervical ripening

目的观察口服米索前列醇与插Foley导尿管在促宫颈成熟中的应用价值。方法选择2015年6月至2017年6月东莞市第五人民医妇产科收治的200例具有引产指征的妊娠晚期孕妇为研究对象,按随机数表法将患者分为对照组和观察组,每组100例。对照组给予Foley导尿管促宫颈成熟,观察组给予口服小剂量米索前列醇促宫颈成熟,比较两组孕妇治疗前后的宫颈Bishop评分、分娩方式、第一产程、新生儿出生体质量和新生儿Apgar评分。结果对照组孕妇临产用时为(10.75±3.38) h,明显长于观察组的(7.32±1.46) h;治疗后宫颈Bishop评分为(5.56±1.51)分,明显低于观察组的(7.75±1.62)分,产程用时为(7.36±1.69) h,明显长于观察组的(6.21±1.28) h,剖宫产率为26.0%,明显高于观察组的11.0%;,总治疗有效率为80.0%,明显低于观察组的94.0%,以上各项指标比较差异均具有统计学意义(P<0.05);但两组新生儿Apgar评分、产妇和新生儿并发症比较,差异均无统计学意义(P>0.05)。结论口服小剂量米索前列醇能显著提高足月妊娠产妇Bishop评分及促宫颈成熟疗效、缩短产妇临产时间及产程时间,提高阴道分娩成功率,并发症相对较少,安全性高。

Objective To observe the value of oral misoprostol and Foley catheter in promoting cervical ripening. Methods A total of 200 late pregnancy pregnant women with indications of induced labor, who admitted to from June 2015 to June 2017, were selected and divided into the control group and the observation group according to random number table method, with 100 cases in each group. The control group was given Foley catheter to promote cervical maturation, and the observation group was given oral low dose misoprostol to promote cervical formation. The cervical Bishop score, mode of delivery, first stage of labor, neonatal birth weight, Apgar score of the two groups before and after treatment were compared. Results The parturient time of the control group was(10.75±3.38) h, which was significantly longer than(7.32±1.46) h of the observation group(P<0.05). After the treatment, the cervical Bishop score of the control group was(5.56±1.51), which was significantly lower than(7.75±1.62) of the observation group(P<0.05). The duration of labor in the control group was(7.36±1.69) h, which was longer than(6.21±1.28) h in the observation group(P<0.05). The cesarean section rate in the control group was 26.0% versus 11.0% in the observation group(P<0.05). The curative effect was 80.0% versus 94.0%(P<0.05). However, there was no significant difference in Apgar score, maternal and neonatal complications between the two groups(P>0.05). Conclusion Oral low-dose misoprostol can significantly improve the Bishop score and cervical ripening effect of full-term pregnant women, shorten the parturient time and duration of labor, improve the success rate of vaginal delivery, with relatively few complications and high safety.