COOK宫颈扩张双球囊在瘢痕子宫再次足月妊娠促宫颈成熟和引产中的效果分析

Effect of COOK Cervical Ripening Balloon for Promoting Cervical Ripening and Labor Induction of Scar Uterus Next Full-Term Pregnancy

目的 分析COOK宫颈扩张双球囊在瘢痕子宫再次足月妊娠促宫颈成熟和引产中的效果。方法 选取2014年4月至2016年5月北京市大兴区人民医院产科使用COOK宫颈扩张双球囊拟阴道分娩的瘢痕子宫再次足月妊娠产妇50例,设为双球囊组,另选取同时期使用缩宫素的瘢痕子宫足月妊娠产妇50例,设为缩宫素组,分析两组产妇宫颈成熟的效果、产妇分娩情况和分娩结局情况。结果 双球囊组的产妇宫颈成熟有效率高于缩宫素组[92.0%(46/50)比74.0%(37/50)](P<0.05);双球囊组使用至临产时间和剖宫产率低于缩宫素组[(11.3±1.1)h比(16.5±0.9)h,12.0%(6/50)比30.0%(15/50)](P<0.05);双球囊组产妇产后24h出血量明显少于缩宫素组[(155±49)mL比(216±59)mL],1min新生儿Apgar评分明显高于缩宫素组[(9.1±0.8)分比(7.2±0.8)分],住院时间短于缩宫素组[(5.4±2.5)d比(10.0±3.4)d](P<0.01)。结论 双球囊用于瘢痕子宫再次妊娠足月妊娠能有效促进宫颈成熟,且引产效果显著。

Objective To analyze the effect of COOK cervical ripening balloon in promoting cervical ripening and labor induction of scar uterus next full-term pregnancy. Methods Fifty parturients with scar uterus next full-term pregnancy using COOK cervical ripening ballon to promote cervical ripening in planned vaginal delivery in the Department of Gyne- cology of Beijing Daxing District People′s Hospital from Apr.2014 to May2016 were included as a balloon group;another 50 parturients of full-term pregnancy of scar uterus using oxytocin during the same period were included as an oxytocin group.The effect of maternal cervical ripening,maternal delivery situation and delivery outcomes of the two groups were analyzed. Results The effective rate of maternal cervical ripening in the balloon group was higher than that in the oxytocin group[92.0%(46/50) vs 74.0%(37/50)]( P <0.05);the using COOK cervical ripening balloon to the time of labor and Cesarean section rate of the balloon group were significantly lower than those of the oxytocin group[(11.3±1.1) h vs (16.5 ±0.9) h,12.0%(6/50) vs 30.0%(15/50)]( P <0.05).The postpartum24 h bleeding volume in the balloon group was lower than that in the oxytocin group[(155±49) mL vs (216±59) mL],the neonatal Apgar score was higher than that in the oxytocin group[(9.1 ±0.8) point vs (7.2±0.8) point],and the hospital stay was significantly shorter than that in the oxytocin group[(5.4±2.5) d vs (10.0±3.4) d]( P <0.01). Conclusion Cervical ripening balloon for scar uterus next full-term pregnancy can effectively promote cervical ripening with significant labor induction effect.