羊水过少产妇引产中应用地诺前列酮与双球囊导管促进宫颈成熟效果的对比研究

Comparative study on the effect of promote cervical mature by Dinoprostone and double balloon catheter of oligohydramnios in labor induction

目的:对比羊水过少产妇引产中应用地诺前列酮和双球囊导管促进宫颈成熟的效果。方法:选取自2015年1月~2016年12月期间的86例因羊水过少接受引产术的足月妊娠产妇,随机分为A组和B组各43例。A组采用地诺前列酮阴道栓促进宫颈成熟,B组采用双球囊导管促进宫颈成熟。对比两组患者的宫颈成熟的时间、引产至活跃期的时间、引产至分娩的时间、使用缩宫素的比例、发生胎心异常的比例、宫缩过频比例、需要提前取出地诺前列酮栓或者双球囊导管的比例、分娩方式以及羊水粪染的比例;对比两组患者药物/双球囊导管置入时、引产时的不适感以及产妇的恐惧感的评分结果 ;对比两组的新生儿结局。结果:A组用药至分娩的时间、使用缩宫素的比例显著低于B组,而监测到异常胎心的比例、提前取出药物的比例则显著高于B组;A组置入药物时的不适感评分为(2.29±1.19)分,产妇的恐惧感评分为(2.28±1.26)分,均显著低于B组;两组新生儿结局的对比,差异没有统计学意义。结论:地诺前列酮与双球囊导管促进宫颈成熟的效果相当,地诺前列酮可增加胎心异常的发生率,但是对分娩方式和新生儿结局无显著的影响,两者均可用于羊水过少产妇的引产。

Objective To compare the effect of promote cervical mature by Dinoprostone and double balloon catheter of oligohydramnios in labor induction. Methods 86 cases of full-term pregnant women with oligohydramnios from January 2015 to December 2016 were selected and randomly divided into group A and group B, 43 in each. Group A was treated with dinoprostone and group B was used double balloon catheter to promote cervical ripening. The cervical ripening time, induction to the active period of time, induction to delivery time, proportion of using of oxytocin, proportion of occurrence of abnormal fetal heart, proportion of uterine contraction too frequent, proportion of taking out dinoprostone or double balloon catheter in advance, delivery mode and proportion of meconium stained amniotic fluid were compared between the two groups. The scores of discomfort during drug or double balloon catheter placement and fear of patients were compared between the two groups. The neonatal outcomes were compared between the two groups. Results The induction to delivery time and proportion of using of oxytocin in group A were significantly lower than those of group B. The proportion of occurrence of abnormal fetal heart and the proportion of taking out medication in advance in group A were significantly higher than those of group B. The scores of discomfort during drug placement in group A was(2.29±1.19) points and the scores of fear of patients was(2.28±1.26) points, which were significantly lower than those of group B. The difference of neonatal outcomes between the two groups was not statistically significant. Conclusion The effects of dinoprostone and double balloon catheter to promote cervical ripening are equal. dinoprostone can increase the incidence of abnormal fetal heart, but there is no significant effect on the mode of delivery and neonatal outcomes. Both of them can be used for oligohydramnios.