Foley球囊联合人工破膜在足月引产中的应用

Application of foley catheter ballon and artificial rupture of membranes in term abortion

目的将Foley球囊与人工破膜联合应用于足月引产,观察引产效果和安全性。方法选取2014年6月至2015年2月在宿迁市人民医院住院分娩、有引产指征且宫颈评分<6分的初产妇123例,根据采用的引产方法分为研究组(62例)和对照组(61例)。两组产妇引产前均先用Foley球囊促宫颈成熟,研究组Foley球囊脱落后行人工破膜,再行缩宫素引产;对照组Foley球囊脱落后直接行缩宫素引产。观察两组引产成功率、临产前缩宫素使用时间、剖宫产率、产程时间、产后出血量及不良反应等。结果研究组引产成功率(100.0%)高于对照组(88.5%),剖宫产率(12.9%)和临产前缩宫素使用时间(1.48 h)少于对照组(27.9%、14.18 h),(P<0.05),两组产程时间及产后出血量比较差异无统计学意义(P>0.05),两组均未发生感染及脐带脱垂等不良反应。结论 Floey球囊促宫颈成熟后联合人工破膜能提高引产成功率,降低剖宫产率,且在严密监护下并不增加感染与脐带脱垂的发生率。

Objective To study the effectiveness and safety of combination of Foley catheter ballon and artificial rupture of membranes at term abortion. Methods A prospective randomized controlled trial was conducted. 123 pregnant women with medically indicate for labor induction, single fetuses, cervical score less than six minutes hospitalized in People＇ s Hospital of Suqian City from June 2014 to February 2015 were selected. According to induced labor methods, divided them into the study group （62 cases） and the control group （61 cases）. Before the labor induction, a 16 - F Foley catheter ballon was inserted into cervical canal of all the pregnant women to promote cervical ripening. In the study group, artificial rupture of membranes was applied to the women after the ballon was spontaneously extruded from cervix. Intravenous oxytocin was initiated after the artificial rupture of membranes if necessary. In the control group, intravenous oxytocin was initiated after the ballon was spontaneously extruded from cervix. Compared the induction success rate, the time of using intravenous oxytocin, cesarean section rate, birth process time, the amount of postpartum bleeding and adverse reaction of two groups. Results The induction success rate of the study group （ 100.0 % ） was significantly higher than that of the control group（ 88.5 % ）, and the cesarean section rate （ 12. 9 % ） and time of using oxytocin （ 1.48 h） was significantly less than those of the control group （27.9 %, 14. 18 h） （P 〈 0.05 ）. There was no significant difference in birth process time and the amount of postpartum bleeding between two groups（P 〉0. 05）. There was no infections and umbilical cord prolapsed and other adverse reactions in two groups. Conclusion The combination of Foley catheter ballon and artificial rupture of membranes can significantly improve the success rate of labor induction, and does not increase the incidence of infections and umbilical cord prolapse under careful monitoring.