双球囊导管用于瘢痕子宫足月引产的临床观察

Clinical Observation of Double Balloon Catheter in Term Pregnancy Women With Cesarean Scar

目的探讨瘢痕子宫使用双球囊导管促宫颈成熟及引产后阴道分娩的安全性和有效性。方法以2016年1月—2018年7月本院收治有阴道分娩条件和意愿的59例宫颈未成熟的足月瘢痕子宫作为研究组,以同期分娩的67例足月非瘢痕子宫宫颈未成熟的为对照组,两组均使用双球囊导管促宫颈成熟及引产,比较两组的母婴结局。结果研究组孕产妇的年龄比对照组大,差异具有统计学意义(P<0.05),两组孕产妇引产前后宫颈Bishop评分、引产时间及总产程的差异无统计学意义(P>0.05);两组的剖宫产率、产后出血率、24小时产后出血量、新生儿窒息率的差异无统计学意义(P>0.05)。结论严格把握指征及充分评估阴道分娩条件,双球囊导管可安全有效地用于瘢痕子宫足月妊娠的促宫颈成熟及引产,可降低瘢痕子宫妊娠的再次剖宫产率,同时不增加母婴不良结局。

Objective To investigate the safety and effectiveness of double balloon catheter for promoting cervical maturation and vaginal delivery after induction of labor in scar uterus.Methods From January 2016 to July 2018,59 cases of immature cervix with full-term scar uterus admitted to our hospital with conditions and willingness for vaginal delivery were used as the study group,and 67 cases of immature cervix with full-term nonscar uterus delivered during the same period were used as the control group.Both groups were treated with double balloon catheter to promote cervical maturation and induce labor,and the maternal and infant outcomes of the two groups were compared.Results The age of pregnant women in the study group was older than that in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in cervical Bishop score,labor induction time and total labor between the two groups before and after labor induction(P>0.05).There were no significant differences in cesarean section rate,postpartum bleeding rate,postpartum bleeding volume within 24 hours and neonatal asphyxia rate between the two groups(P>0.05).Conclusion By strictly controlling the indications and fully evaluating the conditions of vaginal delivery,double balloon catheter can be used to promote cervical maturation and induce labor in term pregnancy with scar uterine pregnancy safely and effectively,and can reduce the rate of cesarean section again with scar uterine pregnancy,without increasing the adverse outcomes of mother and child.