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目的:探讨COOK宫颈扩张球囊应用于妊娠晚期单胎孕妇促宫颈成熟及引产的有效性及安全性。方法:收集广州医科大学附属第一医院妇产科2014年1月至2014年12月113例应用COOK宫颈扩张球囊孕妇的临床资料,按照放置球囊前的宫颈Bishop评分分为A组(Bishop评分≤3分,78例)和B组(Bishop评分4-5分,35例),并收集同期直接使用小剂量缩宫素静滴的孕妇设为C组(Bishop评分4~5分,35例),分别比较3组资料中宫颈Bishop评分、引产成功率、分娩情况及对母婴结局的影响。结果:3组资料中2种方法均能在不同程度上达到促宫颈成熟的目的,其中,A、B两组使用COOK宫颈扩张球囊促宫颈成熟有效率均显著高于C组,差异有统计学意义(P<0.05)。A、B两组第一产程时间显著少于C组、引产成功率显著高于C组、剖宫产率显著低于C组,差异均有统计学意义(P<0.05)。A组与B组促宫颈成熟有效率(A组92.31%、B组100%)、阴道分娩率(A组82.05%、B组85.71%)随宫颈初始评分逐渐递增,即宫颈初始评分越高,促宫颈成熟有效率及引产率越高,差异有统计学意义(P<0.05)。3组对母婴结局中产后出血、新生儿评分的比较差异无统计学意义(均P>0.05)。结论:COOK宫颈扩张球囊应用于妊娠晚期单胎孕妇促宫颈成熟及引产有效、安全,可有效提高引产成功率,降低剖宫产率,值得临床推广应用。
Objective: To investigate the effectiveness and safety of COOK cervical dilatation balloon for promoting cervical ripening and induction of labor in single-trimester pregnant women. METHODS: The clinical data of 113 pregnant women with COOK cervical dilatation balloon were collected from the First Affiliated Hospital of Guangzhou Medical University from January 2014 to December 2014, and divided into group A (Bishop score 4 to 5, 35). The pregnant women who underwent intravenous injection of oxytocin in the same period were enrolled in group C (Bishop score 4-5, 35 Cases) were compared three groups of cervical Bishop score, success rate of induced labor, childbirth and the impact on maternal and child outcomes. Results: The two methods in three groups all reached the goal of promoting cervical ripening to varying degrees. Among them, the effective rate of cervical ripening using COOK cervical dilatation balloon in groups A and B were significantly higher than that in group C Significance (P <0.05). The duration of first stage of labor in group A and group B was significantly less than that in group C, the success rate of induced labor was significantly higher than that in group C, and the rate of cesarean section was significantly lower than that in group C (P <0.05). Cervical maturation was effective in group A and group B (92.31% in group A, 100% in group B), and vaginal delivery rate (82.05% in group A and 85.71% in group B) gradually increased with the initial cervical score, ie, the higher the cervical initial score, Promote the rate of cervical ripening and induction of labor the higher the difference was statistically significant (P <0.05). There was no significant difference in neonatal score between the three groups in postpartum hemorrhage between maternal and infant outcomes (all P> 0.05). CONCLUSION: COOK cervical dilatation balloon is effective and safe in promoting uterine cervix maturation and induction of labor in single-trimester pregnant women. It can effectively improve the success rate of induced labor and reduce the rate of cesarean section, which deserves clinical application.