宫颈扩张球囊和前列腺素用于促宫颈成熟的回顾性对照研究

发布时间：2018-01-16 22:05

本文关键词：宫颈扩张球囊和前列腺素用于促宫颈成熟的回顾性对照研究　出处：《现代妇产科进展》2015年06期 　论文类型：期刊论文

【摘要】：目的:探讨宫颈扩张球囊(COOK球囊)和前列腺素(欣普贝生)用于孕足月宫颈条件不成熟孕妇引产的有效性和安全性。方法:回顾分析2012年10月至2013年10月同济大学上海市第一妇婴保健院收治的宫颈Bishop评分6分并使用COOK球囊或欣普贝生引产的足月孕产妇的临床资料。分析两种方法的促宫颈成熟效果、引产效果,并对子宫过度刺激、胎儿窘迫、新生儿窒息等安全性进行比较。结果:COOK球囊组和欣普贝生组的分娩方式无明显差异(阴道分娩率:73.7%vs 72.0%,P=0.62)。两种引产方式自引产至分娩时间间隔比较,差异无统计学差异,但COOK球囊组24h内的阴道分娩率明显低于欣普贝生组(37.9%vs 48.5%,P=0.007)。研究中6例疤痕子宫产妇采用COOK球囊引产,其中5例产妇顺利经阴道分娩,无分娩并发症。COOK球囊组和欣普贝生组的孕产妇、新生儿结局及并发症比较,差异无统计学意义(P0.05)。结论:对足月宫颈条件不成熟孕妇采用宫颈扩张球囊引产,可有效促进患者的宫颈成熟,安全性高且能有效提高引产的成功率,尤其适用于合并疤痕子宫及胎儿宫内窘迫可能的孕产妇,而前列腺素引产更易导致子宫过度刺激,引起相关并发症。
[Abstract]:Objective: to study the expression of prostaglandin (PGE) and prostaglandin (PGE) in cervical dilated balloon (COOK balloon). Efficacy and safety of induction of labor for pregnant women with term cervix condition immature. Methods:. A retrospective analysis of the cervical Bishop score of 6 in the first Shanghai Women and infants Health Care Institute of Tongji University from October 2012 to October 2013 and the use of COOK balloon or Xinpubesheng induction of labor in full-term pregnancy. Clinical data of puerpera. Analysis of two methods to promote cervical maturation effect. Induction of labor, and on the uterine hyperstimulation, fetal distress. Results there was no significant difference in delivery style between the two groups (vaginal delivery rate: 1 / 73.7 vs 72.0%). There was no significant difference between the two types of induced labor from induction to delivery time interval. But the vaginal delivery rate in the COOK balloon group was significantly lower than that in the Simper group within 24 hours (37. 9 vs 48.5%). In the study, 6 cases of scar uterus were induced by COOK balloon, 5 cases of them were delivered successfully via vagina, and there were no complications of delivery. There was no significant difference in neonatal outcomes and complications (P 0.05). Conclusion: cervical dilated balloon induction of labor can effectively promote cervical maturation of pregnant women with term term condition of cervix. It is safe and effective to improve the success rate of induced labor, especially for pregnant women with scar uterus and fetal distress. Prostaglandin induced labor is more likely to cause uterine overstimulation and related complications.
【作者单位】：同济大学附属上海市第一妇婴保健院;
【基金】：上海市浦东新区联合攻关项目PW2014D-8资助
【分类号】：R719.3
【正文快照】： 近年全球剖宫产率明显上升,发达国家为21%,亚洲27.3%,中国46.2%[1]。近年随着疤痕子宫、可疑胎儿宫内窘迫和引产失败孕产妇的增多,剖宫产率不断增高。妊娠晚期引产是产科处理高危妊娠常用的手段之一。目前有妊娠合并症及并发症的高危孕产妇越来越多,其中约20%孕产妇需通过引产

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