COOK水囊在瘢痕子宫足月妊娠经阴道分娩中的应用

Application of COOK Water Sac in Vaginal Delivery of Full-term Pregnancy of ScarredUterus

目的研究COOK水囊在瘢痕子宫足月妊娠经阴道分娩中的应用。方法选择2017年10月～2018年5月在我院足月妊娠经阴道分娩的120例瘢痕子宫孕妇临床资料,随机分为对照组和观察组各60例,对照组采用500 ml林格氏液和2.5 IU缩宫素静滴治疗,观察组在对照组基础上加用COOK水囊。比较两组剖宫产率、产褥感染、产后出血量、新生儿Apgar评分;观察两组胎儿窘迫、活跃期停滞、持续性枕横位发生情况以及不良反应情况。结果观察组剖宫产率低于对照组(21.67%vs 46.67%),差异均有统计学意义(P<0.05);观察组产褥感染、产后出血量、新生儿Apgar评分与对照组比较,差异无统计学意义(P>0.05);观察组胎儿窘迫、活跃期停滞、持续性枕横位与对照组比较,差异无统计学意义(P>0.05);两组均未发生胎盘早剥、子宫破裂、强直子宫收缩等不良反应。结论缩宫素联合COOK水囊引产方法简单,效果优于单用缩宫素,可以降低剖宫产率,提高阴道分娩率,不增加不良反应,适用瘢痕子宫患者。

Objective To study the application of COOK water sac in full term pregnancy and vaginal delivery of scar uterus.Methods From October 2017 to May 2018,clinical data of 120 pregnant women with scar uterus delivered through vagina during term pregnancy in our hospital were selected.Cases were randomly divided into two groups： control group （n = 60） and observation group （n = 60）. The control group was treated with 500 ml Ringer＇s solution and 2.5 IU oxytocin intravenous drip. The observation group was treated with COOK water Sac on the basis of the control group.The rate of cesarean section, puerperal infection, postpartum hemorrhage and neonatal Apgar score were compared between the two groups, fetal distress, active stagnation, occipital transverse position and adverse reactions were observed.Results The rate of cesarean section in the observation group was lower than that in the control group （21.67% vs 46.67%）,the difference was statistically significant （P〈0.05）.There was no significant difference in puerperal infection, postpartum hemorrhage and neonatal Apgar score between the observation group and the control group （P〉0.05）.There was no significant difference in fetal distress, active stagnation and persistent occipital transverse position between the observation group and the control group（P〉0.05）.There were no adverse reactions such as placental abruption, uterine rupture and uterine contraction in both groups.Conclusion Oxytocin combined with COOK water sac induction method is simple, the effect is better than oxytocin alone, can reduce cesarean section rate, increase vaginal delivery rate, increase adverse reactions, and apply to patients with scarred uterus.