孕足月羊水过少孕妇应用不同方式促宫颈成熟引产效果评价

Effect evaluation of different ways of promoting cervical ripening in induced labor for term pregnancy with oligohydramnios

【目的】探讨欣普贝生、宫颈扩张球囊以及缩宫素3种促宫颈成熟方法用于孕足月羊水过少孕妇引产的临床效果。【方法】选取2017年1月至2018年12月本院孕足月、单胎头位、羊水过少、宫颈不成熟孕妇240例作为研究对象,随机纳入欣普贝生组、宫颈扩张球囊组及缩宫素组促宫颈成熟引产,每组80例,分析3组方法促宫颈成熟效果、用药及操作距临产时间、最终分娩方式及妊娠结局情况。【结果】欣普贝生组及宫颈扩张球囊组均有较好促宫颈成熟效果。欣普贝生组用药后24 h内临产率高于缩宫素组及宫颈扩张球囊组,差异具有统计学意义(P<0.05)。宫颈扩张球囊组24 h内临产率亦明显高于缩宫素组,差异有统计学意义(P<0.05);48 h内及72 h内欣普贝生组及宫颈扩张球囊组临产率明显高于缩宫素组,差异有统计学意义(P<0.05),但欣普贝生组与宫颈扩张球囊组临产率比较差异无统计学意义(P>0.05)。宫颈扩张球囊组最终阴道分娩例数明显高于欣普贝生组及缩宫素组,差异有统计学意义(P<0.05)。3组患者之间产后出血量及母体不良事件比较差异无统计学意义(P>0.05)。欣普贝生组胎儿窘迫发生率高于宫颈扩张球囊组及缩宫素组,差异有统计学意义(P<0.05)。【结论】欣普贝生及宫颈扩张球囊均有很好的促宫颈成熟效果,但宫颈扩张球囊对于孕足月羊水过少孕妇引产相对更安全、有效。

【Objective】To explore the clinical effect of three ways of promoting cervical maturation,including Propess,cervical dilation balloon and oxytocin,on induced labor for term pregnancy with oligohydramnios.【Methods】A total of 240 cases of full-term pregnant women were selected in our hospital from January 2017 to December 2018,who had single head position,oligohydramnios and cervical immature.They were randomly assigned into the Propess group,cervical dilation balloon group and oxytocin group to promote cervical mature for induced labor,80 cases per group.The effect of cervical ripening,the time from drug use and operation to labor,final delivery mode and pregnancy outcome of the three ways was compared and analyzed.【Results】According to the Propess group and cervical dilatation balloon group,there was better effect in promoting cervical maturation.The rate of labor in the Propess group was higher than those in the oxytocin group and cervical dilation balloon group within 24 hours after treatment,and the difference was statistically significant(P<0.05).The rate of labor in the cervical dilation balloon group was obviously higher than that in the oxytocin group within24 hours after treatment,and the difference was statistically significant(P<0.05).Within 48 hours and 72 hours,the rates of labor in the Propess group and cervical dilatation balloon group were significantly higher than that in the oxytocin group(P<0.05).However,there was no statistical difference in the incidence rate between the Propess group and cervical dilatation balloon group(P>0.05).The final number of vaginal delivery in the cervical dilatation balloon group was significantly higher than those in the Propess group and oxytocin group,and the difference was statistically significant(P<0.05).There was no significant difference in postpartum hemorrhage and maternal adverse events among the three groups(P>0.05).The incidence of fetal distress in the Propess group was higher than those in the dilatation balloon group and oxytocin group,and the difference was statistically significant(P<0.05).【Conclusion】Both Propess and cervix dilatation balloon have good effect on promoting cervical maturation,but the cervix dilation balloon is safer and more effective on inducing labor for pregnant women with oligohydramnios at term.