欣普贝生和COOK子宫颈扩张球囊引产效果的比较研究

Comparative effectiveness research of COOK balloon catheter and rostaglandin E2 in induction of labor at term

目的比较欣普贝生和COOK子宫颈扩张球囊对足月单胎引产孕妇的促宫颈成熟的效果和母胎并发症。方法 2012年6月—2013年12月复旦大学附属妇产科医院住院分娩的1116例足月引产孕妇,采用宫颈Bishop评分1~2分、3~4分、5分三组分层分析,分别对两组的经阴道分娩率等指标和母胎并发症进行分析。结果宫颈Bishop评分为3~4分时,球囊组(449例)与欣普贝生组(411例)相比,24 h阴道分娩率高于欣普贝生组(77%vs 64%,χ~2=7.018,P<0.05);新生儿窒息发生率低于欣普贝生组(0.7%vs 2%,χ2=2.83,P<0.05);新生儿感染发生率高于欣普贝生组(5.8%vs 2.4%,χ~2=4.67,P<0.05)。两组产后出血率、急产、产道撕裂、胎心率异常、产褥感染发生率无统计学意义(P>0.05)。结论与欣普贝生相比,宫颈Bishop评分3~4分时,COOK球囊促宫颈成熟能提高阴道分娩率,但新生儿感染的潜在风险增加。

Objective To compare the effects of COOK balloon catheter prostaglandin E2（PGE2） and for cervical ripening and induction of labor at term.Methods 1116 pregnant women delivered in Obstetrics and Gynecology Hospital affiliated to Fudan University from Jun 2012 to Dec 2013 were divided into the COOK balloon catheter group（n = 556） and prostaglandin E2（PGE2） group（n = 560）,three levels was stratified and analyzed according to the cervical Bishop score（1-2 score,3-4 score,5 score）.The effects of cervical ripening and complications of term delivery were analyzed.Results In the group of cervical score 3-4 points,the cases number of COOK balloon Catheter and PGE2 were449 and 441.The COOK balloon catheter could effectively increase the successful vaginal birth rate within 24 h（77%vs.64%,χ2= 7.018,P 0.05）,reduced neonatal asphyxia rate（0.7% vs.2.0%,χ~2= 2.83,P 0.05）,but suffered higher incidence of neonatal infection（5.8% vs.2.4%,χ~2= 4.67,P 0.05）.The occurrence of postpartum hemorrhage,precipitous labor,laceration of birth canal,abnormal FHR and puerperal infection were similar in the two groups（P 0.05）.Conclusion When compared with PGE2,induction of labor using COOK balloon catheter resulted in higher successful vaginal delivery rates within 24 h with a higher risk of neonatal infection.