不同容量小水囊在足月妊娠促宫颈成熟中的应用实效性评价

Effectiveness evaluation of different capacity of small water sac in cervical ripening in term pregnancy

目的探讨不同容量小水囊(80 mL和150 mL)在足月妊娠促宫颈成熟中的应用价值。方法 2013年12月至2015年3月德阳市人民医院妇产科共收治96例足月妊娠但宫颈条件不成熟并要求引产的孕妇,随机分成观察组和对照组,各48例,所有孕妇接受小水囊法促宫颈成熟。观察组使用80 mL小水囊,对照组使用150 mL小水囊。比较两组宫颈成熟有效率、第一产程时间、产后出血量、新生儿体质量、脐带脱垂率及并发症发生情况。结果观察组宫颈成熟有效率为95.8%(46/48),对照组为97.9%(47/48),两组宫颈成熟有效率差异无统计学意义(P>0.05);观察组第一产程时间、产后出血量、新生儿体质量、脐带脱垂率分别为(6.3±1.9)h、(134.7±23.2)mL、(3.5±0.8)kg和0,对照组为(6.0±1.8)h、(132.5±24.0)mL、(3.6±0.6)kg和4.1%(2/48),两组第一产程时间、产后出血量、新生儿体质量差异均不具有统计学意义(P>0.05),而观察组脐带脱垂率明显低于对照组(P<0.05);两组并发症发生率差异不具有统计学意义(P>0.05),但对照组出现2例产道撕裂。结论不同容量小水囊在足月妊娠促宫颈成熟中均具有确切的效果,但80 mL小水囊的脐带脱垂率更低,并发症发生率更低,值得临床推广。

Objective To explore the effectiveness of different capacity（ 80 ml vs 150 ml） of small water sac in cervical ripening in term pregnancy. Methods A total of 96 cases of term pregnancy,whose cervical conditions were not mature and who required induced labor in the hospital from October 2013 to March 2015 were randomized into the observation group and the control group,each group with 48 cases. All patients received small water capsule method to promote cervical ripening,observation group using 80 ml small water sac,while the control group using 150 mL small water capsule. Efficiency of cervical ripening,the first stage of labor time,postpartum hemorrhage,neonatal weight,umbilical cord prolapse rate and complications in the two groups were compared. Results The effective rate of cervical ripening in observation group was 95. 8%（ 46 /48）,while that in the control group was 97. 9%（ 47 /48）,and the difference in two groups was not statistically significant（ P〈0. 05）; the first stage of labor time,postpartum hemorrhage,neonatal weight,umbilical cord prolapse rate in observation group were（ 6. 3 ± 1. 9） h,（ 134. 7 ± 23. 2） mL,（ 3. 5 ± 0. 8） kg and 0,respectively,while those in the control group were（ 6. 0 ± 1. 8） h,（ 132. 5 ± 24. 0） mL,（ 3. 6 ± 0. 6） kg and 4. 1%（ 2 /48）,respectively,and the difference in first stage of labor time,postpartum hemorrhage,neonatal weight in two groups was not statistically significant（ P〈0. 05）,but umbilical cord prolapse rate was significantly lower in observation group（ P〈0. 05）; the difference in complication rate was not statistically significant（ P〈0. 05）,but the control group had two cases of the birth canal tear. Conclusion The different capacity of small water sac in term pregnancy to promote cervical ripening both has the exact effect,but for the 80 ml small water sac,its umbilical prolapse rate is lower,the complication rate is lower,so it is worth further promotion in the clinics.