硬膜外麻醉镇痛对COOK双球囊引产效果和母婴结局的影响

Influence of epidural analgesia on effect of labor induction by COOK double ballon and maternal and neonatal outcomes

目的探讨足月妊娠初产妇硬膜外麻醉镇痛对COOK双球囊引产效果和母婴结局的影响。方法回顾性分析我院2017年12月至2018年12月行COOK双球囊引产的91例足月妊娠初产妇的临床资料,按照是否接受硬膜外麻醉镇痛分为无痛分娩组和常规分娩组。观察比较2组患者的分娩方式以及阴道分娩患者的产程、母婴并发症和抗生素使用情况。结果无痛分娩组的阴道分娩率为91.67%,常规分娩组为50.91%。阴道分娩患者中无痛分娩者的第一产程、第二产程均比常规分娩者长;球囊后24h内阴道分娩率、破水后12h内阴道分娩率均低于常规分娩患者;产前发热率、抗生素使用率和产后出血量均明显高于常规分娩患者,差异均有统计学意义(P<0.05)。2组患者的新生儿窒息率比较差异无统计学意义(P>0.05)。结论无痛分娩可提高COOK球囊引产成功率,但延长了产程,会对分娩造成不良影响,应予重视和预防。

Objective To explore the influence of epidural analgesia(EA) on the effect of term labor induction of primiparous women by COOK double ballon,and evaluate the maternal and neonatal outcomes. Methods The data of 91 primiparous women who received COOK double ballon for induction of term labor were retrospectively analyzed.The cases received EA were named as group EA+COOK and others were named as group COOK.The mode of delivery was observed and compared between the two groups.The duration of labor,maternal complications,infant complications and medication of antibiotic of the patients delivered vaginally were observed and compared between the two groups.Results The vaginal delivery rate was 91.67% in the group EA+COOK and 50.91% in the group COOK.The first stage of labor and the second stage of labor in group EA+COOK were longer than those in group COOK,the vaginal delivery rate within 24 hours after balloon delivery and the vaginal delivery rate within 12 hours after rupture of membrance in group EA+COOK were lower than those in group COOK,and the rate of prenatal fever,the usage rate of antibiotics and the amount of postpartum hemorrhage in group EA+COOK were significantly higher than those in group COOK,the differences were significant( P <0.05).There was no statistical difference in the incidence of neonatal asphyxia between the two groups.Conclusion EA can promote the effectiveness of COOK double ballon for induction of term labor of primiparous women,whereas,more attention and interventions were needed because EA will prolong the labor stage and result in some adverse events .