宫颈扩张球囊在瘢痕子宫再次妊娠孕妇孕晚期引产中的应用效果研究

Study on the application effect of cervix dilatation balloon in late pregnancy induced labor of pregnant women with scar uterus

目的:探讨并研究用宫颈扩张球囊对孕晚期的瘢痕子宫再次妊娠孕妇进行辅助引产的效果。方法:选取2019年7月至2020年7月期间在广东省深圳市罗湖区妇幼保健院进行引产的60例瘢痕子宫再次妊娠孕妇与60例非瘢痕子宫再次妊娠孕妇(这些孕妇均具有进行引产的指征)作为研究对象。将其中60例瘢痕子宫再次妊娠孕妇作为观察组,将其中60例非瘢痕子宫再次妊娠孕妇作为对照组。为两组孕妇均采用宫颈扩张球囊进行辅助引产,然后比较其各项临床指标。结果:干预后,两组孕妇的Bishop宫颈成熟度评分、宫颈成熟的优良率、总产程、阴道分娩率、产后24 h内的出血量及不良分娩结局的发生率相比,差异无统计学意义(P>0.05)。在两组孕妇中,因胎儿宫内窘迫、引产失败及产程停滞转为进行剖宫产手术孕妇的占比相比,差异无统计学意义(P>0.05)。两组孕妇所产新生儿窒息的发生率及出生后1 min的新生儿Apgar评分相比,差异无统计学意义(P>0.05)。观察组孕妇与对照组孕妇所产新生儿的平均体重分别为(3.20±0.18)kg与(3.58±0.26)kg,二者相比差异有统计学意义(P<0.05)。结论:对于具有引产指征的孕晚期瘢痕子宫再次妊娠孕妇来说,用宫颈扩张球囊对其进行辅助引产是安全、可行的,不会增加其不良分娩结局的发生率。

Objective:To explore and study the effect of assisted induction of labor with cervical dilating balloon on pregnant women with scar uterus in the third trimester.METHODS:From July 2019 to July 2020 in Luohu Maternal and Child Health Hospital of Shenzhen City,Guangdong Province,60 pregnant women with second pregnancy with scar uterus and 60 pregnant women with second pregnancy without scar uterus(all of these pregnant women had indications for labor induction)were selected as the research subjects.Among them,60 pregnant women with scar uterus were taken as the observation group,and 60 pregnant women with non-scar uterus were taken as the control group.For the two groups of pregnant women,cervical expansion balloon was used for assisted labor induction,and then the clinical indicators were compared.Results:After intervention,there were no significant differences in Bishop’s cervical maturity score,excellent rate of cervical maturation,total length of labor,vaginal delivery rate,postpartum blood loss within 24 h,and incidence of adverse childbirth outcomes between the two groups(P>0.05).There was no statistical significance in the proportion of women who were converted to cesarean section due to fetal distress,failure of induction of labor and labor stagnation in the two groups(P>0.05).There was no significant difference in the incidence of neonatal asphyxia and Apgar score 1 min after birth between the two groups(P>0.05).The average weight of newborns born in the observation group and the control group was(3.20±0.18)kg and(3.58±0.26)kg,respectively,and the difference between them was statistically significant(P<0.05).Conclusion:It is safe and feasible to use cervical dilating balloon for assisted labor induction for pregnant women with scar uterus in late pregnancy with indications of labor induction,and it will not increase the incidence of adve rse childbirth outcomes.