米索前列醇和宫颈扩张球囊单独与不同顺序联合应用在妊娠晚期引产中的效果

Effect of misoprostol and cervical dilatation balloon alone and in different order combination application in late pregnancy induced labor

目的探究米索前列醇和宫颈扩张球囊单独与不同顺序联合应用在妊娠晚期引产中的效果。方法选取2019年7月至2020年10月本院接收的180例妊娠晚期符合引产指征孕妇为研究对象,按照类层抽样法将其分为A、B、C、D组,各45例,依次采取米索前列醇阴道给药引产、宫颈扩张球囊引产、先放置宫颈扩张球囊后口服米索前列醇引产、先口服米索前列醇后放置宫颈扩张球囊引产。比较四组的Bishop评分、引产效果、分娩用时、分娩结局及母婴并发症发生情况。结果四组孕妇引产后的Bishop评分均高于引产前,差异具有统计学意义(P<0.05);四组孕妇引产后的Bishop评分比较结果:D组>C组>B组>A组(P<0.05)。四组孕妇的引产效果比较,差异具有统计学意义(P<0.05);D组的引产总有效率显著高于A组,差异具有统计学意义(P<0.05);四组孕妇的引产总有效率比较结果:A组<B组<C组<D组。四组孕妇的第一、二、三产程时间、总产程时间、引产至临产时间比较,差异具有统计学意义(P<0.05);C、D组的第一、二、三产程时间、总产程时间、引产至临产时间均明显短于A、B组,差异具有统计学意义(P<0.05)。四组孕妇的分娩结局比较,差异无统计学意义(P>0.05)。四组孕妇的并发症发生情况比较,差异具有统计学意义(P=0.000);B、D组孕妇的并发症总发生率显著低于A组,差异具有统计学意义(P<0.05);四组新生儿的并发症发生情况比较,差异无统计学意义(P>0.05)。结论米索前列醇和宫颈扩张球囊的引产效果明显,且先口服米索前列醇后放置宫颈扩张球囊引产的效果更佳,值得临床推广应用。

Objective To explore the effect of misoprostol and cervical dilatation balloon alone and in different order combination application in late pregnancy induced labor.Methods A total of 180 pregnant women who met the indications of induced labor in the late pregnancy admitted in our hospital from July 2019 to October 2020 were selected as the research objects.According to the stratified sampling method,the pregnant women were divided into group A,B,C and D,with 45 cases in each group,and induced labor by vaginal administration of misoprostol,cervical dilatation balloon,placing cervical dilatation balloon before oral administration of misoprostol,and oral administration of misoprostol before placing cervical dilatation balloon in turn.The Bishop score,effect of induced tabor,delivery time,delivery outcome and occurrence of maternal and infant complications were compared among the four groups.Results The Bishop score of pregnant women after induced labor in the four groups was higher than that before induced labor,and the difference was statistically significant(P<0.05);the comparison results of Bishop score of pregnant women after induced labor in the four groups was as follows:the group D>the group C>the group B>the group A(P<0.05).There was significant difference in the effect of induced labor among the four groups(P<0.05);the total effective rate of induced labor in the group D was significantly higher than that in the group A,and the difference was statistically significant(P<0.05);the comparison results of total effective rate of induced labor of pregnant women in the four groups was as follows:the group A<the group B<the group C<the group D.There were significant differences in the time of the first,second and third stage of labor,total labor time and time from induction to labor among the four groups(P<0.05);the time of the first,second and third stage of labor,total labor time and time from induction to labor in the group C and D were significantly shorter than those in the group A and B,and the differences were statistically significant(P<0.05).There was no significant difference in delivery outcome among the four groups(P>0.05).There was significant difference in the incidence of complications of pregnant women among the four groups(P=0.000);the total incidence of complications of pregnant women in the group B and D was significantly lower than that in the group A,and the difference was statistically significant(P<0.05);there were no significant difference in the incidence of neonatal complications among the four groups(P>0.05).Conclusion Misoprostol and cervical dilatation balloon have obvious effect on induced labor,and oral administration of misoprostol before placing cervical dilatation balloon has better effect,which is worthy of clinical promotion and application.