双球囊导管联合人工破膜和缩宫素在足月妊娠引产中的应用效果观察

Application of the cervical dilation double-balloon catheter combined with artificialamnion membrane rupture and oxytocin in induction of labor at term

目的研究分析应用双球囊导管联合人工破膜和缩宫素在足月妊娠引产中的效果。方法回顾性分析在该院实行计划分娩的90例足月妊娠、具有引产指征、宫颈Bishop评分≤5分的初产妇,随机分为两组,两组均行双球囊导管促进宫颈成熟,观察组取出球囊后经人工破膜,并给予缩宫素静滴引产,对照组取出球囊后等待自然临产,比较两组孕(产)妇的引产效果和母婴结局。结果观察组和对照组用球囊12 h后的宫颈Bishop评分[(6.9±0.9)分、(6.8±0.7)分]均较用球囊前[(3.3±1.0)分、(3.0±1.1)分]升高(P<0.01)。观察组的引产成功率(91.1%)高于对照组(71.1%)(P<0.05),总产程时间[(7.5±3.0)h]短于对照组[(15.3±6.5)h](P<0.01)。观察组的阴道分娩率(86.7%)显著高于对照组(40.8%)(P<0.05),两组的产后2 h出血量、产时发热、软产道损伤及新生儿窒息情况比较差异无统计学意义(P>0.05)。结论应用双球囊导管联合人工破膜和缩宫素能够有效地促进宫颈成熟,缩短产程,促进阴道分娩,值得临床应用。

Objective To observe the application of the cervical dilation double-balloon catheter combined with artificialmembrane rupture and oxytocin in induction of labor at term. Methods Ninety full-term pregnancy women with indications of induced abortion,and cervical Bishop scores ≤5 were collected and randomly divided into two groups. The cervical dilation double-balloon catheters were used to mature cervix. The observation group（ n = 45）was treated with artificial rupture of membrane and intravenous drop of oxytocin in induction of late pregnancy and spontaneous parturition was performed on the control group（ n = 45） after the balloons were withdrawn. The effect of induction and the outcome of newborn were compared between the two groups. Results The cervical Bishop scores were elevated after the application of the cervical dilation double-balloon catheters（ P〈0. 01）. The success rates of abortion and vaginal delivery in the observation group were significantly higher than those in the control group（ P〉0. 05）. The childbirth process was significantly shorter in the observation group than that in the control group（ P〈0. 01）. There were no significant differences in postpartum blood loss,intrapartum fever,pelvic soft tissues rupture and asphyxia of the newborn between the two groups（ P〉0. 05）. Conclusion Application of the cervical dilation double-balloon catheter combined with artificial rupture of membrane and oxytocin contribute to maturing cervix,shortening the childbirth process and increasing the vaginal delivery rate.