COOK球囊在孕晚期羊水过少孕妇中促宫颈成熟的应用价值

Application value of COOK balloon for promoting cervical maturation in late-trimester pregnant women with oligohydramnios

目的探讨COOK球囊在孕晚期羊水过少孕妇中促宫颈成熟的应用价值。方法回顾性分析192例孕晚期羊水过少行促宫颈成熟孕妇,其中102例孕妇使用COOK球囊促宫颈成熟治疗为球囊组,另90例孕妇使用欣普贝生促宫颈成熟为对照组,分别比较两组的舒适度、促宫颈成熟有效性、引产至分娩的总时间、缩宫素使用率、分娩方式、总产程时间、急产率、产钳助娩率、胎儿窘迫率、会阴Ⅱ度以上裂伤率、产后并发症及新生儿评分等指标。结果与对照组相比,球囊组急产率、会阴Ⅱ度以上裂伤率及胎儿窘迫率明显降低,差异均有统计学意义(均P<0.05);球囊组引产至分娩的总时间、总产程时间及缩宫素使用率明显高于对照组,差异均有统计学意义(均P<0.05);两组在舒适度、促宫颈成熟有效性、阴道分娩率、中转剖宫产率、产钳助娩率、产褥感染率、产后出血量及新生儿Apgar评分及结局等方面比较均无统计学差异(均P>0.05)。结论COOK球囊在晚孕期羊水过少孕妇促宫颈成熟方面与欣普贝生相当,对新生儿结局无影响,急产率、会阴裂伤率、胎儿窘迫发生率均低,更加适用于羊水过少孕妇的促宫颈成熟治疗。

Objective To assess the application of COOK balloon for promoting cervical maturation in late-trimester pregnant women with oligohydramnios.Methods One hundred and ninety-two late-trimester pregnant women with oligohydramnios admitted in Huzhou Maternal and Child Health Care Hospital were enrolled in the study.One hundred and two pregnant women were treated with COOK balloon for cervical maturation(balloon group)and 90 pregnant women were treated with Dinoprostone(control group).The degree of comfort,the effectiveness of cervical maturation,the total time from induction of labor to delivery,the usage rate of oxytocin,mode of delivery,total duration of labor,precipitate labor rate,forceps delivery rate,fetal distress rate,the rate of perineal laceration above degree II,postpartum complications,neonatal score and other indicators were compared between the two groups.Results Compared with the control group,the precipitate labor rate,the rate of perineal laceration above degree II and fetal distress rate in balloon group were significantly lower than those in the control group(P<0.05).The total time from induction of labor to delivery and the total duration of labor in balloon group were significantly longer and the usage rate of oxytocin was significantly higher than those in the control group(all P<0.05).There were no significant differences in the degree of comfort,the effectiveness of cervical maturation,vaginal delivery rate,rate of transfer to cesarean section,forceps delivery rate,postpartum infection rate,postpartum bleeding volume,neonatal Apgar score and outcome between the two groups(P>0.05).Conclusion COOK balloon can promote cervical maturation in late-trimester pregnant women with oligohydramnios,the function of which is similar to Dinoprostone.It has no effect on neonatal outcomes;the incidence of precipitate birth rate,perineal laceration rate and fetal distress is low.