双腔水囊结合缩宫素用于妊娠晚期糖尿病孕妇引产的效果观察

Application of double-lumen water balloon combined with oxytocin in labor induction of pregnant women with diabetes mellitus in the third trimester of pregnancy

目的:探讨双腔水囊结合缩宫素用于妊娠晚期糖尿病孕妇引产的临床效果。方法:抽取2018年3月至2022年3月郑州颐和医院收治的妊娠晚期糖尿病孕妇84例,根据双色球法分为对照组与观察组,每组42例。对照组予以地诺前列酮栓进行引产,观察组采用双腔水囊结合缩宫素进行引产。比较两组引产效果、产后出血量、总产程、治疗前后宫颈成熟度评分、安全性、妊娠结局及新生儿Apgar评分。结果:观察组引产总有效率(95.24%,40/42)高于对照组(71.43%,30/42),P<0.05。观察组产后出血量[(174.62±21.54)ml]少于对照组[(235.60±40.11)ml],总产程[(10.23±1.87)h]长于对照组[(7.29±2.11)h],P<0.05。两组治疗前后宫颈成熟度比较,差异均未见统计学意义(P均>0.05)。安全性方面,观察组宫缩过频、胎盘早剥、胎儿窘迫的发生率均低于对照组,差异有统计学意义(P<0.05)。不良妊娠结局方面,观察组剖宫产率(19.05%,8/42)低于对照组(38.10%,16/42),P<0.05,但两组产后出血率、产后尿潴留率、新生儿窒息率、新生儿宫内感染率、胎膜早破率比较差异均未见统计学意义(P均>0.05)。观察组产后1、5、10 min新生儿Apgar评分均高于对照组(P均<0.05)。结论:妊娠晚期糖尿病孕妇采取双腔水囊结合缩宫素引产,可提高引产总有效率,明显改善妊娠结局,产后新生儿Apgar评分良好。

Objective To investigate the application of double-lumen water balloon combined with oxytocin treatment in labor induction of pregnant women with diabetes mellitus in the third trimester of pregnancy.Methods A total of 84 pregnant women with diabetes mellitus in the third trimester who were admitted to Zhengzhou Yihe Hospital from March 2018 to March 2022 were selected,and they were divided into control group and observation group by dichromatic sphere method,with 42 cases in each group.The control group was given dinoprostone suppository to induce labor,while the observation group was given double-lumen water balloon combined with oxytocin to induce labor.The effectiveness of labor induction,postpartum hemorrhage,total labor process,cervical maturity score before and after treatment,safety,pregnancy outcome and neonatal Apgar score were compared between the two groups.Results The total effective rate of labor induction in the observation group(95.24%,40/42)was higher than that in the control group(71.43%,30/42),P<0.05.The amount of postpartum hemorrhage in the observation group was(174.62±21.54)ml,smaller than the(235.60±40.11)ml in the control group,and the total labor process in the observation group was(10.23±1.87)h,longer than the(7.29±2.11)h in the control group(P<0.05).There was no statistically significant difference in cervical maturity score between the two groups before and after treatment(all P>0.05).In terms of safety,the incidence of frequent uterine contractions,placental abruption,and fetal distress in theobservation group were lower than those in the control group,with statistically significant differences(P<0.05).In terms of adverse pregnancy outcomes,the cesarean section rate in the observation group(19.05%,8/42)was lower than that in the control group(38.10%,16/42),P<0.05;however,there was no significant difference in the rates of postpartum hemorrhage,postpartum urinary retention,neonatal asphyxia,intrauterine infection of neonates,and premature rupture of membranes between thetwo groups(all P>0.05).At 1,5 and 10 minutes postpartum,the scores of Apgar in the observationgroup were higher than those in the control group(all P<0.05).Conclusions The use of doublelumenwater balloon combined with oxytocin in inducing labor in pregnant women with diabetes mellitusin the third trimester can improve the total effective rate of labor induction,significantly improvepregnancy outcomes,moreover,the postpartum neonatal Apgar score is good.