米非司酮配合cook球囊在瘢痕子宫胎儿畸形中晚孕引产中的应用

Application of Mifepristone Combined with Cook Balloon in Labor Induction of Malformed Fetuses in Women with Scar Uterus during Mid-and Late-Pregnancy

目的探讨米非司酮配合cook球囊在瘢痕子宫(前次剖宫产)胎儿畸形中晚孕引产中的应用效果。方法将2016年1月至2017年12月因胎儿畸形在湖北省妇幼保健院引产的瘢痕子宫(前次剖宫产)中晚孕孕妇90例作为研究对象,按知情同意原则分为研究组(米非司酮配合cook球囊,30例)和对照组(米非司酮配伍利凡诺,60例),观察两种治疗方案的临床效果。结果研究组的规律宫缩开始时间、总产程时间、总引产时间都明显少于对照组,差异有统计学意义(均P<0.05);研究组产后出血量略少于对照组,但差异无统计学意义(P>0.05);研究组组织残留率及产后发热人数明显少于对照组,差异有统计学意义(均P<0.05);2组在引产成功率、软产道损伤发生率上的差异无统计学意义(均P>0.05),均未发生子宫破裂等严重并发症。结论在瘢痕子宫(前次剖宫产)胎儿畸形中晚孕引产中采用米非司酮配合cook球囊,能够有效缩短产程,减少引产术后并发症,不增加产后出血量,有临床推广应用价值。

Objective To explore the efficacy of mifepristone combined with cook balloon in labor induction of malformed fetus in women with scar uterus caused by previous cesarean section during mid-and latc-prcgnancy.Methods Ninety women in mid-and latc-prcgnancy who had scar uterus and required termination of pregnancy due to fetal malformation in our hospital between January 2016 and December 2017 were enrolled in the study."They were divided into study groupCmifcpristone+cook balloon group n=30)and control groupCmifcpristone+rivanol group?n=60)?and the clinical effects of the two groups were observed and compared.Results T'he start time of regular contractions?the time between regular contraction and placental delivery and the total labor induction time were significantly shorter in the study group than in the control groupCall P<0.05).The postpartum blood loss was slightly less in the study group than in the control groups but the difference was not statistically significant(P>0.05).The rate of tissue residues and the number of postpartum fever were significantly lower in the study group than in the control groups and the differences were statistically significantCall P<0.05).Thcre was no statistically significant difference in the success rate of induced labor and the incidence of injury of soft tissues in birth canal between the two groupsCall P>0.05),and no serious complications such as uterine rupture occurred in either group.Conclusion The application of mifepristone combined with cook balloon in labor induction of malformed fetuses in women with scar utcrusCcaused by previous cesarean section.)during mid-and latc-prcgnancy can effectively shorten the length of labor and reduce the postoperative complications,without increasing the postpartum hemorrhage,t has clinical application value.