低位水囊与地诺前列酮栓用于促进宫颈成熟中的对比分析

Comparative analysis the application of low position water sac and dinoprostone suppository in promoting cervical ripening

目的 对低位水囊及地诺前列酮栓(欣普贝生)在促进宫颈成熟中的作用效果及安全性进行比较,旨在寻找一种安全有效的促进宫颈成熟的方法。方法 选择2017年1月-2018年4月在本院住院有引产指征的孕妇85例作为研究对象。随机分为,低位水囊组(45例)和欣普贝生组(40例)两组。比较两组治疗前后的宫颈Bishop评分、剖宫产率、引产成功率、产程情况、新生儿情况及并发症发生率。结果两组治疗前后宫颈Bishop评分皆有明显改善,但两组比较,无统计学差异(P>0.05)。两组临产时间、产程时间及新生儿情况比较,无统计学差异(P>0.05)。低位水囊组阴道分娩率达84.4%,引产成功率达97.8%,其中73.3%后续应用了人工破膜加催产素引产。而欣普贝生组阴道分娩率62.5%,引产成功率82.5%,其中42.5%加用了催产素引产。两组比较,有统计学差异(P<0.05)。两组胎膜早破、胎儿窘迫、产后出血的发生率比较无统计学差异(P>0.05)。欣普贝生组宫缩过频的发生率为32.5%,与低位水囊组比较有统计学差异(P<0.05)。另外欣普贝生组出现2例胎盘早剥,低位水囊组出现1例隐性脐带脱垂,1例宫内感染。结论 欣普贝生及低位水囊两种方法均可作为促进宫颈成熟的安全有效的方法,但其具有各自的优缺点,应用过程中,应严格把握好适应症及禁忌症,根据患者情况,予个体化处理,严密监护,保证母婴安全。

Objective In order to find a safe and effective method to promote cervical ripening,the effect and safety of low position water sac and dinoprostone suppository in promoting cervical ripening were compared.Methods From January 2017 to April 2018,85 pregnant women who had indications of induced labor in our hospital were included in the study.They were randomly divided into two groups,45 cases in low position water sac group and 40 cases in the dinoprostone suppository group.The cervical Bishop score,cesarean section rate,success rate of induced labor,birth process,neonatal status and complications were compared between the two groups before and after treatment.Results The Bishop scores of the two groups improved significantly after treatment,but there was no significant difference between the two groups.There was no significant difference between the two groups in the duration of labor,the duration of labor and the condition of the newborn.The vaginal delivery rate of low position water sac group reached 84.4%,and the success rate of induced labor reached97.8%.73.3%of them were followed up by artificial rupture of membranes and oxytocin induced labor.The vaginal delivery rate was 62.5%,and the induced labor rate was 82.5%,42.5%of them were induced by oxytocin in the dinoprostone suppository.There were statistical differences between the two groups.There was no significant difference in the incidence of premature rupture of membranes,fetal distress and postpartum hemorrhage between the two groups.The incidence of contractions frequency in the dinoprostone suppository group was 32.5%,which was significantly different from that in the low position water sac group.In addition,2 cases of placental abruption,1 case of recessive umbilical cord prolapse and 1 case of intrauterine infection occurred in dinoprostone suppository group.Conclusions The two methods of dinoprostone suppository and low position water sac could be used as a safe and effective way to promote cervical ripening.However,they have their own advantages and disadvantages.In the process of application,we should strictly grasp the indications and contraindications,and give individual treatment according to the patient’s situation,monitoring closely,to ensure the safety of mothers and infants.