宫颈COOK双球囊与依沙吖啶羊膜腔注射在瘢痕妊娠中期引产中效果比较

Comparison of effect of cervical COOK double balloon combine with rivanol amniocentesis for induction of labor during the second trimester of pregnant women with scar uterus

目的:探讨宫颈COOK双球囊与利凡诺羊膜腔注射在瘢痕妊娠中期引产中的效果。方法:将2016年1月—2018年1月本院引产的120例健康孕妇,按照随机数字表法分为3组,COOK双球囊+米非司酮组(40例)、COOK双球囊+利凡诺组(40例)、利凡诺+米非司酮组(40例)。各组均给予相应的米非司酮口服、COOK双球囊置入、利凡诺注射。比较各组宫颈Bishop评分、血压、引产效果及引产出血情况等。结果:COOK双球囊+米非司酮组、COOK双球囊+利凡诺组引产处理后宫颈Bishop评分高于引产处理前,且高于利凡诺+米非司酮组(P<0.05)。与利凡诺+米非司酮组相比,COOK双球囊+米非司酮组及COOK双球囊+利凡诺组的引产显效率均较高,产程开始至胎儿娩出时间及引产总时间均较短(P<0.05)。各组的宫缩发动时间、引产出血情况比较无差异(P>0.05),各组均未出现宫颈撕伤、子宫破裂、大出血等。结论:瘢痕子宫妊娠中期应用宫颈COOK双球囊引产可有效促进宫颈成熟,缩短引产时间,且并发症少,安全性较好。

Objective:To investigate the effect of cervical COOK double balloon combine with rivanol amniocentesis for induction of labor during the second trimester of pregnant women with scar uterus.Methods:120 pregnant women during the second trimester with scar uterus were enrolled in the study from January 2016 to January 2018,and they were divided into 3 groups according to the random number table.40 women in group A were treated by COOK double balloon combined with mifepristone,40 women in group B were treated by COOK double balloon combined with rivanol amniocentesis,and 40 women in group C were treated by rivanol combined with mifepristone.The cervical Bishop score,blood pressure,effect of induction of labor,and bleeding volume of women were compared among the three groups.Results:The Bishop scores of women in group A or group B increased after treatment,and which was significant higher than that of women in group C(P<0.05).The effect of women in group A and group B was significant higher than that of women in group C(P<0.05),and the time of induction of labor of women in group A or group B was significant shorter than that of women in group C(P<0.05).There were no significant differences in uterine contraction time and bleeding volume among the three groups(P>0.05).There were no any women with cervical tears,uterine rupture,or profuse bleeding in the three groups.Conclusion:Cervical COOK double balloon for pregnancy induction of labor during the second trimester of patients can effectively promote cervical ripening,shorten the time of induction of labor,and have fewer complications.