宫颈球囊扩充器在妊娠中晚期引产孕妇促宫颈成熟中的应用效果

Effect of cervical balloon dilator on promoting cervical maturation in pregnant women with mid- and late pregnancy induced labor

摘要:

目的 分析探讨宫颈球囊扩张器对妊娠中晚期引产孕妇宫颈成熟程度及阴道分娩率的影响。方法 选取2021年11月至2022年11月南阳市卧龙区妇幼保健院收治的79例采用催产素引产的患者作为对照组，选取2021年12月至2022年12月南阳市卧龙区妇幼保健院收治的232例使用宫颈球囊扩充器进行促宫颈成熟的孕妇作为试验组，其中又将孕20~28周放弃妊娠的患者划分为试验A组，将孕37~42周的正常妊娠患者划分为试验B组；试验B组中又将6 h后即拔除水囊的患者划分为B1组，将12 h后拔除水囊的患者划分为B2组。对于试验A组患者在12 h内不进行干预，等待其自然脱落，对于12 h后仍然没有临产的患者进行水囊拔除并且采用宫颈Bishop评分进行评估，分析患者的妊娠结局。对于试验B组患者则分别在B1和B2组患者拔除水囊后进行宫颈评分，并分析其妊娠结局。结果 试验组患者有23例因为各种原因转手术，对照组患者中有19例患者需要进行剖宫产手术；B1组患者的住院时间和待产时间以及产程时间均显著高于B2组患者（均P<0.05）。对照组患者待产时间和产程时间、住院时间等均显著长于试验B组患者（t=12.020，t=3.102，t=5.544，均P<0.05）；两组患者的新生儿窒息率和感染率差异无统计学意义（P>0.05）；试验B组患者的阴道分娩率为87.57%，显著高于对照组患者的75.94%（χ2=99.647，P<0.05）。B1组患者的出血量为（179.27±33.94）mL，显著多于B2组患者的（153.29±22.20）mL（t=6.014，P<0.05）；B1组患者的试产成功率为77.78%，显著低于B2组患者的93.40%（χ2=8.858，P<0.05）。结论 对妊娠中晚期引产孕妇采用宫颈球囊扩充器进行促宫颈成熟的效果显著优于催产素引产，同时能够大大降低患者的剖宫产率，促进患者阴道分娩，值得在临床上加以推广运用。

Abstract:

Objective To analyze the effect of cervical balloon dilator on cervical maturation and vaginal delivery rate.Methods Seventy-nine patients with oxytocin induced labor admitted in Nanyang Wolong Maternal and Child Health Care Hospital from November 2021 to November 2022 were selected as control group, 232 pregnant women using cervical balloon expanders to promote cervical maturation in the hospital from December 2021 to December 2022 were selected as experimental group, among them, patients who gave up pregnancy at 20 to 28 weeks of gestation were divided into experimental group A, and normal pregnant patients at 37 to 42 weeks of gestation were divided into experimental group B. In experimental group B, patients who had their water sacs removed 6 hours later were divided into B1 group, and patients who had their water sacs removed 12 hours later were divided into B2 group. For the patients in the experimental group A, no intervention was performed within 12 hours, waiting for their natural abscission; for the patients were still not in labor after 12 hours, water sac extraction was performed and the evaluation was conducted with the cervical Bishop score, so as to analyze the pregnancy outcome of the patients. For the patients in the experimental group B, cervical scoring was performed for the patients in the B1 and B2 groups after the removal of the water sac, and the pregnancy outcome was analyzed.Results Twenty-three patients in the experimental group were transferred to surgery for various reasons, and 19 patients in the control group needed cesarean section. The length of hospital stay, time to labor and duration of labor in group B1 were significantly higher than those in group B2 (all P<0.05). In the control group, the time to labor, duration of labor and hospital stay were significantly longer than those in the experimental group B (t=12.020, t=3.102, t=5.544, all P<0.05). There was no significant difference in neonatal asphyxia rate and infection rate between the two groups (P>0.05). The vaginal delivery rate in group B was 87.57%, significantly higher than 75.94% in control group (χ²=99.647, P<0.05). The blood loss in group B1 was 179.27±33.94 mL, significantly higher than that in group B2 (153.29±22.20 mL) (t=6.014, P<0.05). The success rate of B1 group was 77.78%, significantly lower than 93.40% of B2 group (χ²=8.858, P<0.05).Conclusion The effect of using cervical balloon expander to promote cervix maturation is better than that of oxytocin. It can greatly reduce the rate of cesarean section and promote vaginal delivery. It is worth popularizing in clinic.