宫颈扩张球囊对足月妊娠者促宫颈成熟及分娩结局的影响

The influence of cervical dilatation balloon on cervical maturation and delivery outcomes in women with full term pregnancy

目的:比较单球囊、双球囊、欣普贝生3种方法在足月妊娠促宫颈成熟与引产的临床效果。方法:回顾性收集2018年1月-2019年6月本院足月分娩孕妇300例临床资料,均有引产指征。根据促宫颈成熟方法不同分为单球囊组、双球囊组、欣普贝生组各100例。比较3组孕妇宫颈Bishop评分变化,引产至临产时间、总产程时间、产后出血量、分娩方式等。结果:单球囊组、双球囊组、欣普贝生组促宫颈成熟有效率(92%、89%、91%)无差异(P>0.05);剖宫产率欣普贝生组(28%)高于单球囊和双球囊组(9%、11%)(P<0.05);宫颈Bishop评分增加值单球囊组(4.0±1.4分)、双球囊组(3.5±1.6分)、欣普贝生组(3.6±1.6分)无差异(P>0.05);欣普贝生组用药至临产时间(13.9±10.8h)和总产程时间(7.1±2.6h)均短于单、双球囊组(P<0.05);产后出血量单球囊组(335±91ml)、双球囊组(358±100ml)、欣普贝生组(348±89ml)比较无差异(P>0.05);新生儿出生体重单球囊组(3476±331g)、双球囊组(3482±296g)、欣普贝生组(3483±296g)比较无差异(P>0.05);结论:3种引产方式促宫颈成熟效果相当,欣普贝生组引产至临产所用时间及总产程时间更短,但剖宫产率更高,在引产效果无差异前提下建议应用宫颈球囊促宫颈成熟更安全。

Objective: To compare the clinical effects of single balloon, double balloon, and dinoprostone suppositories for the uterine cervical maturation and induction of labor of pregnant women with full term pregnancy. Methods: A retrospective analysis was performed on 300 pregnant women with full term pregnancy who had accepted induction of labor from January 2018 to June 2019. According to the different methods of promoting cervical maturity, they were divided into 3 groups, which included 100 women experienced promoting cervical maturity by single balloon in group A, 100 women experienced promoting cervical maturity by double balloon in group B, and 100 women experienced promoting cervical maturity by dinoprostone suppositories in group C. The cervical Bishop scores, the time from induction to labor, total labor time, postpartum hemorrhage volume, and delivery methods of women were compared among the three groups. Results: There were no significant different in the effective rate of cervical ripening(92%, 89% vs. 91%) among the three groups(P>0.05). The cesarean section rate of women in group C(28%) was significant higher than that(9%) of women in group A and that(11%) of women in group B(P<0.05). The value added of cervical Bishop score of women in group A was 4.0±1.4 points, which had no significant different from that(3.5±1.6 points) of women in group B and that(3.6±1.6 points) of women in group C(P>0.05). The time from drug used to delivery and the total duration of labor of women in group C were 13.9± 10.8 h and 7.1±2.6 h, which were significant shorter than those in group A and B(P<0.05). There was no significant different in postpartum blood loss of women among group A(335±91 ml), group B(358±100 ml) and group C(348±89 ml)(P>0.05). There was no significant difference in neonatal birth weight among group A(3476±331 g), group B(3482±296 g) and group C(3483±296 g)(P>0.05).Conclusion:There is no significant difference in the effect of promoting cervical maturation of the three induction of labor methods.The time from induction of labor to labor and the total labor time by dinoprostone suppositories are shorter than those by single or double balloon,but the cesarean rate of women after dinoprostone suppositories used is higher.So it is safer to promote cervical maturity by single or double balloon if no different effect of induction of labor.