地诺前列酮和米索前列醇用于宫颈球囊促宫颈成熟失败者的疗效观察

Observation on the efficacy of dinoprostone and misoprostol in failed cervical ripening by balloon

目的探讨Foley’s球囊促宫颈成熟失败后,继续使用地诺前列酮和米索前列醇促宫颈成熟及引产的临床观察。方法选取68例宫颈Foley’s球囊促宫颈成熟失败产妇作为研究对象,随机分为地诺前列酮组(D组)和米索前列醇组(M组),D组使用地诺前列酮序贯促熟,M组使用米索前列醇,比较两组引产有效率、24 h内分娩率、分娩方式、产妇及围生儿并发症发生率等。结果两组患者阴道总分娩率66.2%;两组患者引产效率及剖宫产率比较差异无统计学意义(P>0.05);两组患者子宫过度刺激发生率比较差异有统计学意义(P<0.05),但若及时发现并处理,并不会增加不良妊娠结局发生;两组患者缩宫素应用和新生儿感染比较差异有统计学意义(P<0.05)。与M组相比,D组能够缩短住院时长,降低总住院费用。结论宫颈Foley’s球囊促成熟失败者,继续促熟后约2/3可以获得阴道分娩。对于医疗资源匮乏地区,米索前列醇经济、方便且安全;对于医疗配备良好单位,严密监护下使用地诺前列酮能够提高引产效率且不增加不良反应及不良结局发生。

Objective To observe the clinical effects of dinoprostone and misoprostol on cervical ripening and induced labor after failed cervical ripening of Foley’s balloon.Methods Sixty-eight cases of failed cervical ripening by Foley’s balloon were randomly divided into dinoprostone group(D group)and misoprostol group(M group),with D group receiving dinoprostone to sequential ripened and M group receiving misoprostol to promote cervical ripening.The effective rate of induced labor,delivery rate within 24 hours,mode of delivery,complications of puerpera and perinatal infants were compared between the two groups.Results The total vaginal delivery rate of the two groups was 66.2%.The efficiency of induced labor and cesarean section rate presented no difference between the two groups(P>0.05).The comparison of uterine hyperstimulation shown statistically significant difference(P<0.05)between two groups.However,the incidence of adverse pregnancy outcomes will not increase by timely detection and treatment.Oxytocin use and neonatal infection were significantly different between two groups(P<0.05).Hospital stay and costs were less for group D.Conclusion Continuing promoting cervical repining after failed by Foley’s balloon can help about 2/3 women delivery from vaginal.Misoprostol is cost-effective,convenient and safe in areas where medical resources are scarce.For well-equipped medical units,the use of dinoprostone under intensive care can improve the efficiency of induced labor without increasing adverse outcomes.