COOK宫颈扩张球囊与控释地诺前列酮用于妊娠晚期促进宫颈成熟的疗效比较

Comparison of COOK Cervical Ripening Balloon and Controlled-Release Dinoprostone for Cervical Ripening in Third Trimester of Pregnancy

目的探讨COOK宫颈扩张球囊与地诺前列酮用于妊娠晚期促进宫颈成熟的临床疗效。方法将200例具有引产指征的孕妇按随机数字表法分为对照组和观察组,每组100例。对照组给予控释地诺前列酮治疗,观察组给予COOK宫颈扩张球囊治疗。采用Bishop评分法观察2组孕妇促宫颈成熟度,对2组Bishop评分、分娩方式、剖宫产率及分娩状况(诱发临产时间、总产程、产后出血、新生儿Apgar评分及胎儿其他状况)进行比较。结果观察组促宫颈成熟有效率为94.0%,对照组促宫颈成熟有效率为83.0%,2组比较差异有统计学意义(P<0.05)。观察组Bishop评分高于对照组[(8.39±0.92)分比(7.12±0.35)分]、剖宫产率低于对照组(8.0%比19.0%)、诱发临产时间短于对照组[(14.7±2.8)h比(16.4±3.4)h]、产后出血量少于对照组[(160.2±49.3)mL比(180.8±56.1)mL],均P<0.05。2组总产程、新生儿Apgar评分及胎儿宫内窘迫症发生率比较差异均无统计学意义(均P>0.05)。结论 COOK宫颈扩张球囊促宫颈成熟疗效显著,可显著降低孕妇剖宫产率。

Objective To compare the clinical efficacies of COOK cervical ripening balloon and controlled-release dinoprostone for cervical ripening in the third trimester of pregnancy.Methods Two hundred pregnant women with indications for labor induction were randomly treated with either controlled-release dinoprostone（control group,n=100）or COOK cervical ripening balloon（observation group,n=100）.Cervical status was assessed according to the Bishop score.Bishop score,delivery mode,cesarean section rate,and delivery status（induced labor time,labor duration,postpartum hemorrhage,Apgar score,etc.）were compared between the two groups.Results Compared with control group,COOK cervical ripening balloon significantly increased the successful cervical ripening rate（94.0% vs 83.0%）and Bishop score（8.39±0.92 vs 7.12±0.35）,decreased the cesarean section rate（8.0% vs 19.0%）and postpartum hemorrhage（160.2±49.3）mL vs（180.8±56.1）mL）,and shortened the induced labor time[（14.7±2.8）h vs（16.4±3.4）h]（P〈0.05）.There were no significant differences in the labor duration,Apgar score and incidence of fetal distress between the two groups（P〉0.05）.Conclusion COOK cervical ripening balloon is effective for cervical ripening and reducing cesarean section rate.