低位小水囊与米索前列醇用于孕晚期引产的比较

Comparison of Low Water Sac and Misoprostol for Late Pregnancy Induction

目的研究探讨Foley尿管低位小水囊与小剂量米索前列醇用于孕晚期引产治疗的疗效比较.方法将102例有引产指征的孕妇,随机分为2组,水囊组50例,米索前列醇组52例,观察比较2组促宫颈成熟有效性、孕妇依从性、不良反应、分娩结局(临产开始时间、第一产程时间、阴道分娩率、分娩期胎儿窘迫发生率、新生儿Apgar评分)等2组间差异是否有统计学意义.结果米索前列醇组孕妇依从性高于水囊组(P<0.01),阴道分娩率高于水囊组(P<0.05);水囊组置入水囊时少量宫颈出血发生率高于米索前列醇组(P<0.05),米索前列醇组宫缩过频发生率高于水囊组(P<0.05);促宫颈成熟有效性、临产开始时间、第一产程时间、分娩期胎儿窘迫发生率及新生儿Apgar评分比较,2组差异均无统计学意义(P>0.05).结论两者用于孕晚期引产均较安全、有效,不增加宫内感染率及分娩期胎儿窘迫发生率;小剂量米索前列醇孕妇依从性高,更易被孕妇接受,且阴道分娩率更高,但宫缩过频发生率较高,而水囊少量宫颈出血发生率高.

Objective To investigate the effect of low water sac of Foley catheter and low dose of misoprostol for late pregnancy induction. Methods One hundred and two patients with induced abortion were randomly divided into 2 groups, 50 cases in the water sac group and 52 cases were in misoprostol group. The effectiveness of cervical ripening, pregnant women compliance, adverse reactions and birth outcomes （in the start time, the first stage of labor time, vaginal delivery rate, fetal distress incidence period and neonatal Apgar score） were observed and statistically compared between the two groups. Results The compliance of pregnant women in misoprostol group is higher than those in water sac group （P〈0.01） , vaginal delivery rate in misoprostol group is higher than those in water sac group （P〈0.05） ; the incidence of a small amount of cervical bleeding is higher when the water bag was inserted in the water sac group （P〈0.05） . The uterine contraction frequency in misoprostol group is higher than in the water sac group （P〈0.05） ; the effectiveness of cervical ripening, medication to labor time, first labor time, incidence of fetal distress and neonatal Apgar score of two groups are not significant difference （P ：〉0.05） Conclusions Both of these medicines for late pregnancy induction are safe and effective; they don＇t increase the rate of intrauterine infection and neonatal outcome. The compliance of pregnant women with small dose of misoprostol is higher. The small dose of misoprostol is more susceptible to pregnant women, and has a higher rate of vaginal delivery. But the uterine contraction frequency with small dose of misoprostol is higher. The small amount of cervical bleeding with the water sac is higher.