双球囊导管促足月妊娠产妇宫颈成熟的临床研究

发布时间：2018-01-15 04:18

本文关键词：双球囊导管促足月妊娠产妇宫颈成熟的临床研究　出处：《上海交通大学学报(医学版)》2017年01期 　论文类型：期刊论文

【摘要】：目的·探讨双球囊导管在促足月妊娠产妇宫颈成熟及引产中的有效性和安全性。方法·采用前瞻性对照研究的方法,选择2014年5月—2016年1月有引产指征、单胎初产、胎儿头位、胎膜完整、宫颈Bishop评分6分的152例足月妊娠产妇进行分析;其中51例采用双球囊导管促宫颈成熟者为球囊组,51例采用地诺前列酮栓者为对照组A,50例采用小剂量缩宫素者为对照组B,观察比较3组促宫颈成熟和引产的效果、分娩方式、围产结局、产程等。结果·152例产妇中,球囊组促宫颈成熟有效48例(94.1%),对照组A有效47例(92.2%),对照组B有效16例(32.7%),球囊组总有效率显著高于对照组B(P=0.000),与对照组A差异无统计学意义(P=0.872)。球囊组阴道分娩37例(72.6%),对照组A阴道分娩39例(76.5%),对照组B阴道分娩19例(38.0%),球囊组阴道分娩率明显高于对照组B(P=0.006),与对照组A差异无统计学意义(P=0.747)。而3组的总产程、羊水污染率、新生儿窒息率、产后出血等母儿结局之间差异无统计学意义(P0.05)。引产过程中产妇不良反应发生率球囊组明显低于对照组A(P=0.003),与对照组B差异无统计学意义(P=0.873)。结论·双球囊导管促宫颈成熟及引发自然分娩效果与地诺前列酮栓无明显差异,但明显优于单纯使用缩宫素,且其不良反应发生率明显低于地诺前列酮栓。
[Abstract]:Objective: to investigate the efficacy and safety of double balloon catheter in promoting cervical maturation and induced labor in term pregnant women. From May 2014 to January 2016, 152cases of term pregnant women with indication of induced labor, first delivery of single fetus, fetal head position, intact fetal membrane and Bishop score of cervix were analyzed. Among them, 51 cases were treated with double balloon catheter to promote cervical maturation, 51 cases were treated with diloprostone suppository as control group, 50 cases were treated with low-dose oxytocin as control group B. Objective: to observe and compare the effects of three groups in promoting cervix maturation and induced labor, delivery mode, perinatal outcome, labor process, etc. Results of 152 cases of parturient, 48 cases of balloon group were effective in promoting cervix maturation. Control group A was effective in 47 cases and control group B was effective in 16 cases. The total effective rate in the balloon group was significantly higher than that in the control group (0.000). There was no significant difference between the control group and the control group (P < 0. 872). There were 37 cases of vaginal delivery in the balloon group and 39 cases in the control group (76. 5%). The vaginal delivery rate in the control group was significantly higher than that in the control group (38.0% vs 38.0%). The vaginal delivery rate in the balloon group was significantly higher than that in the control group (0.006). There was no significant difference between group A and control group (P < 0. 747), but the total labor process, amniotic fluid contamination rate and neonatal asphyxia rate in the 3 groups were not significantly different from those in the control group. There was no significant difference between maternal and fetal outcomes such as postpartum hemorrhage (P 0.05). The incidence of adverse reactions of parturient in the balloon group was significantly lower than that in the control group (P 0.05). There was no significant difference between the two groups (P < 0. 873). Conclusion there is no significant difference between the effect of double balloon catheter on cervix maturation and spontaneous delivery. But it was better than using oxytocin alone, and the incidence of adverse reaction was significantly lower than that of diloprostone suppository.
【作者单位】：复旦大学附属华山医院宝山分院妇产科;上海交通大学医学院附属新华医院妇产科;
【基金】：上海市宝山区科技创新医学卫生专项基金(13-E-27)~~
【分类号】：R719.3
【正文快照】： 我国孕妇剖宫产率高达46%,远高于世界平均水平。的宫颈成熟度密切相关。促宫颈成熟及引产方法的选择对对需要终止妊娠但无剖宫产指征的足月孕妇进行引产,低剖宫产率至关重要。目前国内常用的促宫颈成熟的方法可提高自然分娩率,降低剖宫产率,更好地保障母婴安全[1]。由于孕妇

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