一次性球囊宫颈扩张器联合催产素在晚期妊娠期糖尿病引产中的临床研究

Clinical study of disposable balloon cervical dilator combined with oxytocin in induced labour for pregnant women with advanced gestational diabetes mellitus

目的探讨在晚期妊娠期糖尿病引产中使用一次性球囊宫颈扩张器联合催产素的临床价值。方法选择2019年1月—2021年1月在本院住院70例需要终止妊娠的合并妊娠期糖尿病晚期妊娠初产妇作为研究对象,按引产方式不同分为观察组和对照组两组,每组各35例。对照组使用催产素引产,观察组使用一次性球囊宫颈扩张器联合催产素引产。比较两组促宫颈成熟有效率、引产成功率、剖宫产率、宫颈Bishop评分、产妇临床指标和不良事件发生率。结果观察组产妇的促宫颈成熟有效率、引产成功率明显高于对照组,而剖宫产率明显低于对照组,差异有统计学意义(P<0.05);促宫颈成熟后,两组产妇宫颈Bishop评分均高于促宫颈成熟前,且观察组产妇宫颈Bishop评分高于对照组,差异有统计学意义(P<0.05);观察组产妇的第一产程、第二产程及总产程时间、产后2 h出血量明显低于对照组,新生儿Apgar评分明显高于对照组,差异有统计学意义(P<0.05);两组产妇的空腹血糖比较,差异无统计学意义(P>0.05);观察组产妇不良事件发生率(8.57%)显著低于对照组(28.57%),差异有统计学意义(P<0.05)。结论在晚期妊娠期糖尿病引产中,使用一次性球囊宫颈扩张器联合催产素进行引产,其促宫颈成熟有效率及引产成功率高,能缩短产程,改善母婴结局,操作简单可靠,安全性高,值得在临床上推广应用。

Objective To explore the clinical value of disposable balloon cervical dilator combined with oxytocin in induced labor for women with late gestational diabetes mellitus.Methods From January 2019 to January 2021,70 primiparas with advanced gestational diabetes who needed termination of pregnancy in our hospital were selected as the research objects.According to different ways of induced labor,they were divided into observation group(n=35)and control group(n=35).The control group used oxytocin to induce labor,and the observation group used disposable balloon cervical dilator combined with oxytocin to induce labor.The effective rate of promote cervical maturity,success rate of induced labor,rate of cesarean section,Bishop score of cervix uteri,maternal clinical indicators and incidence of adverse events of two groups were compared.Results The effective rate of cervical ripening and success rate of induced labor in observation group were higher than those in the control group,and the cesarean section rate of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).After the intervention,Bishop score of of both two groups were higher than those before ripening,and Bishop score of the observation group was higher than that of the control group(P<0.05).The first,second and total stages of labor,the amount of postpartum hemorrhage in 2 hours in the observation group were significantly lower than those in the control group,the Apgar score of neonates was significantly higher than that of control group(P<0.05).There was no significant difference in fasting blood glucose between the two groups(P>0.05).The incidence of adverse events in the observation group(8.57%)was significantly lower than that in the control group(25.71%),and the difference was statistically significant(P<0.05).Conclusions The use of disposable balloon cervical dilator combined with oxytocin in induced abortion of late gestation diabetes has high cervical ripening efficiency and high success rate of induced labor.It could shorten the labor process and improve the maternal and infant outcomes.It is simple,reliable and safe,and is worthy of clinical application.