一次性尿管联合人工破膜及催产素在足月妊娠产妇促宫颈成熟中的应用

Application of disposable urinary catheter combined with artificial rupture of membrane and oxytocin in promoting cervical ripening in full-term pregnant women

目的研究一次性尿管联合人工破膜及催产素在足月妊娠产妇促宫颈成熟中的应用效果。方法回顾性分析2021年3月至2023年10月濮阳县人民医院收治的165例足月妊娠产妇的临床资料,按照不同催产方法分组,其中55例采用缩宫素催产产妇纳入A组,59例采用人工破膜+缩宫素催产产妇纳入B组,51例采用一次性尿管+人工破膜+缩宫素催产产妇纳入C组。比较三组产妇催产前及催产12 h的宫颈成熟度(Bishop评分);比较三组产妇促宫颈成熟有效率,以及催产至规律宫缩时间,第一产程、第二产程及第三产程时间,剖宫产及阴道分娩率和产妇的母婴结局。结果三组产妇催产12 h的Bishop评分均高于催产前,C组产妇Bishop评分为(8.92±1.53)分,明显高于B组的(7.72±1.24)分及A组的(6.75±0.81)分,B组产妇的Bishop评分高于A组,差异均有统计学意义(P<0.05);C组产妇的促宫颈成熟有效率为94.12%,明显高于B组的81.36%及A组的63.64%,B组产妇的促宫颈成熟有效率高于A组,差异均有统计学意义(P<0.05);C组产妇催产至规律宫缩时间、第一产程、总产程分别为(14.29±2.70)h、(5.27±0.74)h、(6.11±1.15)h,明显短于B组的(15.75±3.04)h、(6.60±0.83)h、(7.14±1.39)h及A组的(16.98±3.07)h、(7.81±1.24)h、(7.96±1.66)h,B组产妇的催产至规律宫缩时间、第一产程、总产程明显短于A组,差异均有统计学意义(P<0.05)。C组产妇的自然分娩率为88.24%,明显高于B组的71.19%及A组的50.91%,且B组明显高于A组,差异均有统计学意义(P<0.05);C组产妇产后尿潴留率明显低于B组及A组,差异均有统计学意义(P<0.05),但B组产妇与A组产妇产后尿潴留率比较差异无统计学意义(P>0.05);三组产妇产后的并发症总发生率及新生儿不良结局发生率比较差异均无统计学意义(P>0.05)。结论一次性尿管联合人工破膜及催产素对足月妊娠产妇促宫颈成熟效果显著,且能够缩短产程,提高自然分娩率,安全性高。

Objective To explore the application effect of disposable urinary catheter combined with artificial rupture of membrane and oxytocin in promoting cervical ripening in full-term pregnant women.Methods The clinical data of 165 full-term pregnant women admitted to Puyang People's Hospital from March 2021 to October 2023 were ret-rospectively analyzed,and they were divided into three groups according to different methods of inducing labor.Among them,55 pregnant women who were induced by oxytocin were included in group A,59 pregnant women by artificial rup-ture of membrane+oxytocin were included in group B,and 51 by disposable catheter+artificial rupture of membrane+oxytocin were included in group C.Cervical ripeness(Bishop score)before labor induction and at 12 h of labor were compared among the three groups.The effective rate of promoting cervical ripening,the time from induced labor to regu-lar contraction,the time of the first,second,and third stage of labor,the rate of cesarean section,the rate of vaginal deliv-ery,as well as the maternal and infant outcomes were compared among the three groups.Results The Bishop scores of parturients in three groups at 12 hours after induced labor were significantly higher than those before induced labor;the Bishop score in group C was(8.92±1.53)points,which were significantly higher(7.72±1.24)points in group B and(6.75±0.81)points in group A,and the score in group B was significantly higher than that in group A;the differences were all statistically significant(P<0.05).The effective rate of promoting cervical ripening in group C was 94.12%,sig-nificantly higher than that in group B(81.36%)and group A(63.64%);the rate in group B was significantly higher than that in group A;the differences were statistically significant(P<0.05).The time from induced labor to regular contrac-tion,the first stage of labor,the total stage of labor in group C were(14.29±2.70)h,(5.27±0.74)h,(6.11±1.15)h,which were significantly shorter than(15.75±3.04)h,(6.60±0.83)h,(7.14±1.39)h in group B and(16.98±3.07)h,(7.81±1.24)h,(7.96±1.66)h in group A;the three indicators in group B were significantly shorter than those in group A;the differences were statistically significant(P<0.05).The rate of vaginal delivery in group C was 88.24%,which was significantly high-er than 71.19%in group B and 50.91%in group A;the rate in group B was significantly higher than that in group A;the differences were statistically significant(P<0.05).The rate of postpartum urinary retention in group C was significantly lower than that in group B and that in group A(P<0.05),but there was no statistically significant difference in the rate be-tween group B and group A(P>0.05).There was no significant difference in the total incidence of postpartum complica-tions and neonatal adverse outcomes among the three groups(P>0.05).Conclusion Disposable urinary catheter com-bined with artificial rupture of membrane and oxytocin has a significant effect on promoting cervical ripening in full-term pregnant women,which can shorten the labor process and improve the natural delivery rate,with high safety.