放置宫颈球囊促宫颈成熟运用于自然分娩孕妇的临床价值探讨

Clinical Efficacy of Placement of Cervical Balloon for Cervical Ripening in Pregnant Women with Natural Delivery

目的:探讨宫颈球囊促宫颈成熟运用于自然分娩孕妇的临床价值。方法:选取我院2019年2月至7月78例自然分娩初产妇,按照治疗方法分组,各39例。缩宫素组予以缩宫素,宫颈球囊组子以宫颈球囊+缩宫素。对比两组剖宫产分娩率、自然分娩率、24 h内自然分娩率、第一产程、第二产程及总产程时间、新生儿不良结局(胎儿窘迫、新生儿窒息、转入NICU)、治疗前、治疗12 h后Bishop评分。结果:治疗12h后两组Bishop评分均升高,宫颈球囊组Bishop评分较缩宫素组高(P<0.05);宫颈球囊+缩宫素组剖宫产分娩率20.51%、较缩宫素组43.59%低;自然分娩率79.49%,较缩宫素组56.41%高;24 h内自然分娩率76.92%;较缩宫素组23.08%高(P<0.05);宫颈球囊+缩宫素组第一产程时间,总产程时间较缩宫素组短(P<0.05),两组第二产程时间对比,差异无统计学意义(P>0.05);宫颈球囊+缩宫素组胎儿窘迫率7.69%,新生儿窒息率2.56%,转入NICU率0.00%与缩宫素组(5.13%、12.82%、2.56%)对比,差异无统计学意义(P>0.05)。结论:放置宫颈球囊促宫颈成熟运用于自然分娩孕妇,可增加宫颈成熟度,有利于缩短产程,提高自然分娩率。

Objective: To explore the clinical value of cervical balloon placement in promoting cervical maturation in natural delivery pregnant women. Methods: 78 cases of pregnant women with natural delivery in our hospital were selected and divided into two groups (39 cases in each group) according to the treatment method. Oxytocin group was given oxytocin, and cervical balloon group was placed cervical balloon. The cesarean section delivery rate, natural delivery rate, natural delivery rate within 24 hours, first stage of labor time, second stage of labor time, total stage of labor time, adverse neonatal outcomes (neonatal asphyxia, neonatal distress, transfer to NICU), Bishop score before treatment and 12 hours after treatment were compared between the two groups. Results: After 12 hours of treatment, the Bishop score of both groups increased, the Bishop score of cervical balloon group was higher than that of oxytocin group (P<0.05);the cesarean delivery rate of cervical balloon group was 20.51%, lower than that of oxytocin group 43.59%;the natural delivery rate was 79.49%, higher than that of oxytocin group 56.41%;and the natural delivery rate within 24 hours was 76.92%, higher than that of oxytocin group 23.08%(P<0.05). Compared with oxytocin group, the first and total stages of labor in cervical balloon group were shorter(P<0.05), and there was no significant difference in the second stage of labor between the two groups (P>0.05). There was no significant difference of the neonatal asphyxia rate 2.56%, neonatal distress rate 7.69% and NICU transfer rate 0.00% in cervical balloon group combined with that in the cervical balloon group(P>0.05). Conclusion: Placing cervical balloon to promote cervical maturity in pregnant women with natural delivery can increase cervical maturity, shorten the labor process and improve the natural delivery rate.