不同类型球囊在足月妊娠引产中的临床观察

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目的:比较单球囊和双球囊在足月妊娠引产中的作用。方法:对有引产指证的孕妇随机分为单球囊组和双球囊组,于下午17点左右放置水囊,次日上午8点左右取出球囊并给予人工破膜,1小时后小剂量缩宫素静滴,观察引产效果。观察指标包括宫颈Bishop评分,用药到宫缩时间,用药到分娩时间,辅助干预率(人工破膜和催产素使用),产程时间及阴道分娩成功率,产后出血率,产程期间发热,新生儿体重和Apgar评分。结果:单球囊组和双球囊组使用前后宫颈评分均明显提高,单球囊组为3.74±0.82(分)和7.19±0.90(分),双球囊组为3.72±0.73(分)和7.15±0.98(分);单球囊组和双球囊组用药到出现宫缩时间分别为524.30±459.88(分钟)和561.42±446.52(分钟),用药到分娩时间分别为1433.13±514.95(分钟)和1551.07±530.18(分钟);第一产程时间单球囊和双球囊分别为501.70±297.37(分钟)和477.91±284.63(分钟),第二产程时间分别为38.13±24.04(分钟)和47.07±35.18(分钟);阴道分娩率分别为64.3%和68.4%;两组比较差异均无统计学意义;单球囊需要人工破膜率75%,双球囊需要人工破膜率89%,两组比较差异有统计学意义,两组催产素使用率分别为81%和84%,比较差异无统计学意义。新生儿平均出生体重单球囊组3442.26±529.97(g),双球囊组3381.65±452.71(g);比较差异无统计学意义。产程间发热分别为6.0%和6.3%。两组比较差异无统计学意义。结论:两种类型球囊均具有促宫颈成熟作用,加用人工破膜和催产素静滴均可以达到安全有效的引产效果,值得基层推广应用。 OBJECTIVE: To compare the effects of single balloon and double balloon on induction of term pregnancy. Methods: Pregnant women with induction of induced labor were randomly divided into single balloon group and double balloon group. The water sac was placed at about 17 o’clock in the afternoon. The balloon was removed at about 8:00 the next day and the artificial rupture was given. After 1 hour, the small dose Oxytocin intravenous infusion, observe the effect of induction of labor. Observational indicators included cervical Bishop score, medication to contractions time, medication to delivery time, assisted intervention rate (artificial rupture of membranes and oxytocin use), labor duration and vaginal delivery success rate, postpartum hemorrhage rate, fever during labor, neonatal weight And Apgar score. Results: Before and after the single balloon group and the double balloon group, the cervical scores were all significantly improved (3.74 ± 0.82 and 7.19 ± 0.90 in the single balloon group and 3.72 ± 0.73 in the double balloon group and 7.15 ± 0.98 (min). The contractile time of single balloon group and double balloon group were 524.30 ± 459.88 (minutes) and 561.42 ± 446.52 (minutes) respectively. The time from delivery to delivery was 1433.13 ± 514.95 (minutes) And 1551.07 ± 530.18 (min) respectively. The time of the first stage of labor was 501.70 ± 297.37 (minutes) and 477.91 ± 284.63 (minutes) for single balloon and double balloon and the second stage of labor were 38.13 ± 24.04 (minutes) and 47.07 ± 35.18 (minutes); vaginal delivery rates were 64.3% and 68.4% respectively; there was no significant difference between the two groups; artificial balloon rupture rate was 75% for single balloon and 89% for double balloon, The difference was statistically significant, the two groups of oxytocin use rates were 81% and 84%, the difference was not statistically significant. The newborn average birth weight of single balloon group 3442.26 ± 529.97 (g), double balloon group 3381.65 ± 452.71 (g); the difference was not statistically significant. Labor fever were 6.0% and 6.3% respectively. No significant difference between the two groups was statistically significant. CONCLUSION: Both types of balloon have the effect of promoting cervical maturation. Combined with artificial rupture of membranes and oxytocin intravenous infusion, safe and effective induction of labor can be achieved, which is worth promoting and applying at the grassroots level.
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