不同促宫颈成熟方式对足月妊娠初产妇分娩情况及新生儿结局的影响

The influence of different methods of promoting cervical ripening on delivery status and neonatal outcome of primiparas in full-term pregnancy

目的探讨双球囊导管与欣普贝生两种促宫颈成熟方式在足月妊娠初产妇的临床疗效。方法选择2018年1月—2020年12月在本院进行引产的672例足月妊娠产妇作为研究对象,随机数表法分为观察组(337例)和对照组(335例)两组。观察组产妇采取双球囊导管引产方式,对照组产妇采取欣普贝生药物引产方式,对两组产妇宫颈成熟情况、分娩情况以及新生儿结局等进行评价。结果引产12小时时,两组产妇Bishop评分均有改善,并且观察组评分为(7.56±1.15)分,高于对照组的(5.89±0.82)分,差异有统计学意义(P<0.05);观察组产妇24小时阴道分娩率为78.93%(266例),高于对照组的72.24%(242例),差异有统计学意义(P<0.05);观察组新生儿出生1分钟和5分钟时Apgar评分分别为(8.65±0.40)分和(9.36±0.25)分,高于对照组的(8.18±0.37)分和(9.24±0.26)分,差异均有统计学意义(P<0.05);但是观察组胎儿窘迫和新生儿窒息等不良新生儿结局的发生率分别为1.48%和2.08%,低于对照组的2.39%和3.28%,但差异没有统计学意义(P>0.05)。结论双球囊促宫颈成熟方式可促进足月妊娠初产妇的宫颈成熟,提高24 h内阴道分娩率,并且对新生儿的安全性较好,有助于产程管理。

Objective To explore the clinical effects of double-balloon catheter and dinoprostone in promoting cervical ripening in full-term pregnancy women.Methods A total of 672 full-term pregnant women who ever had undergone labor induction in Xiamen traditional Chinese medicine hospital from January 2018 to December 2020 were selected as the research objects,and were divided into the observation group(337 cases)and the control group(335 cases)according to random number table method.The observation group was adopted double-balloon catheter to induce labor,and the control group was adopted dinoprostone drug to induce labor.The indicators of cervical ripening status,delivery status and neonatal outcome were evaluated between the two groups.Results At 12 hours after induction of labor,the Bishop scores of the two groups were significantly improved,and the scores of the observation group(7.56±1.15)points were significantly higher than those of the control group(5.89±0.82)points(P<0.05).The 24-hour vaginal delivery rate of the observation group(266 cases,78.93%)was significantly higher than that of the control group(242 cases,72.24%)(P<0.05).The Apgar scores at 1 minute and 5 minutes after birth of the observation group(8.65±0.40)points and(9.36±0.25)points,respectively were significantly higher than those of the control group(8.18±0.37)points and(9.24±0.26)points,respectively(P<0.05).There was no significantly difference in the incidence of fetal distress and neonatal asphyxia in the observation group(1.48%and 2.08%,respectively)and the control group(2.39%and 3.28%,respectively)(P>0.05).Conclusions The promoting cervical ripening method of double-balloon could promote the cervical ripening of full-term pregnancy,increase the vaginal delivery rate within 24 hours,and performance high safety for the newborn,which is helpful for the management of the labor process.