单球囊扩张引产对足月妊娠分娩方式及围产期并发症的影响

The influence of single balloon dilation induced labor on delivery mode and perinatal complications of full term pregnant women

目的:观察单球囊扩张引产对足月妊娠女性分娩方式和围产期并发症的影响。方法:以2017年3月—2018年6月本院计划分娩的249例足月妊娠女性为研究对象,随机数字表法分为单球囊组、双球囊组和阴道栓组各83例,观察各组分娩方式,产程和引产前后Bishop评分,评价促进宫颈成熟水平,测定新生儿体重和1 min Apgar评分,统计医疗费用情况,跟踪围产期并发症情况。结果:单球囊组和双球囊组引产后Bishop评分(7.4±1.5分、7.4±1.5分)无差异但均高于阴道栓组(6.2±1.3分)(t=3.126、3.089,P=0.000、0.000);促宫颈成熟总有效率(92.8%、91.6%)无差异但均高于阴道栓组(78.3%)(χ~2=7.014、5.698;P=0.008、0.017);经阴道分娩率(83.1%、84.3%)无差异但均高于阴道栓组(69.9%)(χ~2=4.055、4.914,P=0.044、0.027);第二产程均长于阴道栓组(t=3.976、4.345,P=0.000、0.000)。单球囊组医疗费少于两外两组(t=3.582、6.714,P=0.000、0.000)。结论:单球囊扩张引产可有效提高足月妊娠女性宫颈成熟度,增加阴道分娩成功率,降低剖宫产率和围产期并发症的发生率,具有与双球囊扩张引产相当的综合疗效和安全性,且医疗成本更低,值得产科临床推广使用。

Objective:To observe the influence of single balloon dilation induced labor on the delivery mode and perinatal complications of full term pregnant women.Methods:249 full term pregnant women were selected as the research objects from March 2017 to June 2018,and all the women were divided into the study group(induced labor by single balloon dilation),the control group 1(induced labor by double balloon dilation),and the control group 2(induced labor by dinoprostone suppository)according to the random number table method.The delivery mode,labor,and cervical Bishop scores of before and after induction of women were recorded.The degree of cervical ripening,the weight of the newborn,the 1 min Apgar score,the medical expenses,and rate of perinatal complications of women were evaluated.Results:The Bishop scores of women in the study group(7.4±1.5 points)or the control group 1(7.4±1.5 points)was significant higher than that(6.2±1.3 points)of women in the control group 2(t=3.126,3.089,P=0.000,0.000).The total effective rate of promoting cervical maturation of women in the study group(92.8%)or the control group 1(91.6%)was significant higher than that(78.3%)of women in the control group 2(χ~2=7.014,5.698,P=0.008,0.017).The vaginal delivery rate of women in the study group(83.1%)or in the control group 1(84.3%)was significant higher than that(69.9%)of in the control group 2(χ~2=4.055,4.914,P=0.044,0.027).The time of the second stage of labor of women in the study group or in the control group 1 was significant longer than that of women in the control group 2(t=3.976,4.345,P=0.000,0.000).The medical expenses of women in the study group was significant lower than that of women in the control group 1 or in the control group 2(t=3.582,6.714,P=0.000,0.000).Conclusion:Single balloon dilatation can effectively improve the cervical maturity of full term pregnant women,increase the success rate of vaginal delivery,and reduce the cesarean section rate,and increase the incidence of perinatal complications.Single balloon dilatation has the same comprehensive efficacy and safety as double balloon dilatation when induced labor,but which has lower medical cost,so it is worthy of clinical application.