宫颈球囊和地诺前列酮栓与缩宫素对妊娠期高血糖引产患者阴道分娩及母婴并发症的影响

Effects of cervical balloon and dinoprostone suppositories and oxytocin on vaginal delivery and maternal and infant complications in patients with gestational hyperglycemia induced labour

目的分析宫颈球囊、地诺前列酮栓与缩宫素在妊娠期高血糖患者引产中的作用,探讨其对分娩方式和母婴并发症发生情况的影响。方法回顾性分析2020年1月至2023年9月许昌市妇幼保健院收治的62例妊娠期高血糖引产患者,根据引产方式分组,联合使用地诺前列酮栓与缩宫素者设为对照组(n=31),在对照组基础上加用宫颈球囊治疗者设为观察组(n=31),对比两组产程、分娩方式、宫颈成熟度、新生儿Apgar评分,并对两组产后出血量、母婴并发症发生率进行对比。结果观察组临产时间为(9.16±1.44)h,第一产程为(6.78±1.32)h,第二产程为(0.82±0.12)h,总产程为(7.54±1.21)h,短于对照组,组间对比差异有统计学意义(P<0.05);观察组阴道分娩率为90.32%,剖宫产率为9.68%,与对照组对应指标对比差异有统计学意义(P<0.05);干预后12 h,两组产前宫颈成熟度对比无差异(P>0.05),干预后24 h,观察组产后宫颈成熟度评分分别为(6.44±0.81)分、(8.18±1.12)分;分娩后5 min,观察组新生儿Apgar评分(9.24±0.44)分高于对照组(8.78±0.36)分。观察组产后2h出血量、产后24 h出血量分别为(156.32±21.75)mL和(178.12±25.44)mL,母婴并发症发生率为6.45%,明显低于对照组,两组对应参数差异有统计学意义(P<0.05)。结论予以妊娠期高血糖引产患者宫颈球囊引产,可促进宫颈成熟,缩短产程,提高阴道分娩率,也可减少产后出血量,改善母婴预后,建议推广应用。

Objective To analyze the effect of cervical balloon,dinoprostone suppositories and oxytocin on induced labor in pregnant patients with hyperglycemia,and to explore the effect on delivery mode and maternal and infant complications.Methods Totally 62 cases of induced labor with hyperglycemia during pregnancy admitted to Xuchang Maternal and Child Health Hospital from January 2020 to September 2023 were retrospectively analyzed,and divided into groups according to the mode of induced labor.Those who used dinoprostone suppositories in combination with oxytocin were set up as the control group(n=31),and those who were treated with cervical balloon based on the control group were set up as the observation group(n=31).The course of labor,mode of delivery,cervical maturity and Apgar score of newborn were compared between the two groups,and the postpartum blood loss and the incidence of maternal and infant complications were compared between the two groups.Results Labor time in observation group was(9.16±1.44)h,the first stage of labor was(6.78±1.32)h,the second stage of labor was(0.82±0.12)h,and the total stage of labor was(7.54±1.21)h,which was shorter than that in control group,and the difference between groups was statistically significant(P<0.05).The vaginal delivery rate and cesarean section rate of the observation group were 90.32% and 9.68% respectively,and there were significant differences compared with the control group(P<0.05).12h after intervention,there was no difference in prenatal cervical maturity between the two groups(P>0.05).24h after intervention,postpartum cervical maturity scores in the observation group were(6.44±0.81)points and(8.18±1.12)points,respectively.At 5 min after delivery,the Apgar score in observation group(9.24±0.44)was higher than that in control group(8.78±0.36).The 2h postpartum blood loss and 24h postpartum blood loss in the observation group were(156.32±21.75)mL and(178.12±25.44)mL,respectively.The incidence of maternal and infant complications was 6.45%,which was significantly lower than that in the control group,and the corresponding parameters were statistically different between the two groups(P<0.05).Conclusion Cervical balloon induction of hyperglycemia induced labor during pregnancy can promote cervical maturity,shorten labor,improve vaginal delivery rate,reduce postpartum blood loss,improve maternal and infant prognosis,and suggest its popularization and application.