摘要
目的观察宫颈双球囊联合催产素、地诺前列酮栓(商品名:欣普贝生)、单纯催产素点滴三种引产方法对妊娠晚期引产结局的影响。方法选取2017年1月至2019年6月因延期妊娠及妊娠合并症需要终止妊娠的孕妇共计303例,按引产方法的不同将其分为球囊组(宫颈双球囊+催产素点滴,n=97),欣普贝生组(地诺前列酮栓,n=111)及催产素组(单独催产素点滴,n=95)。比较3组宫颈成熟度即Bishop评分、开始使用至分娩发动时间、出现规律宫缩至分娩结束时间、产后出血发生率、新生儿窒息率、剖宫产率、剖宫产指征构成比。结果球囊组和欣普贝生组宫颈Bishop评分均高于单纯催产素组(P<0.05)。欣普贝生组分娩发动时间明显快于球囊组及催产素组(P<0.05)。球囊组与欣普贝生组剖宫产率均低于催产素组(P<0.05)。球囊组与欣普贝生组产后出血率及新生儿窒息率相当(P>0.05)。剖宫产指征中,因头盆不称致引产失败为主要原因,占64.3%(36/56);催产素组头盆不称引起引产失败发生率明显高于球囊组、欣普贝生组(P<0.05)。结论相对单纯催产素点滴,宫颈双球囊联合催产素点滴及欣普贝生这两种引产方式更安全,引产效果更好,可以获得更高的自然分娩率,且欣普贝生在分娩发动时间、总产程时间优势明显,临床可以根据孕妇的实际情况选择使用。
Objective To observe the effects of cervical double balloon device,dinoprostone and oxytocin drip on the outcome of induced labor in the third trimester of pregnancy.Methods A total of 303 pregnant women who needed to terminate pregnancy due to delayed pregnancy and complications in our hospital from January 2017 to June 2019 were divided into three groups:balloon group(treatment with cervical double balloon device and oxytocin drip,n=97),dinoprostone group(treatment with dinoprostone alone,n=111),and oxytocin group(treatment with oxytocin drip alone,n=95).Cervical Bishop score,time to onset of labor,time from regular contraction to end of labor,cesarean section index composition ratio,and incidence of postpartum hemorrhage,neonatal asphyxia and cesarean section were compared among the three groups.Results Cervical Bishop score in balloon or dinoprostone group was higher than that in oxytocin group(P<0.05).The initiation time of labor in dinoprostone group was faster than that in balloon or oxytocin group(P<0.05).The rate of cesarean section balloon or dinoprostone group was lower than that in oxytocin group(P<0.05).There were no significant differences in the incidence of postpartum hemorrhage and neonatal asphyxia between balloon group and dinoprostone group(P>0.05).Cephalopelvic disproportion(64.3%,36/56)was the main reason for the failure of labor induction,and the incidence of cephalopelvic disproportion-caused failure of labor induction in oxytocin group was higher than that in balloon or dinoprostone group(P<0.05).Conclusion Both combined treatment with cervical double balloon device and oxytocin drip and treatment with dinoprostone alone are safer and more effective methods for cervical dilation and can achieve higher natural delivery rate than oxytocin drip alone.Furthermore,dinoprostone has an obvious advantage over cervical dilation balloon in improving onset time and duration of labor.There three methods can be chosen according to the actual condition of pregnant woman.
作者
舒俊俊
杨俊
SHU Jun-jun;YANG Jun(Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Nanchang University,Nanchang 330008,China)
出处
《实用临床医学（江西）》
CAS
2020年第2期36-38,59,共4页
Practical Clinical Medicine
关键词
宫颈双球囊
地诺前列酮栓
催产素
引产
延期妊娠
妊娠合并症
cervical double balloon
dinoprostone
oxytocin
induced labor
delayed pregnancy
pregnancy complications
