COOK双球囊与缩宫素促宫颈成熟并引产的对照研究  

A control study of COOK double balloon dilation and oxytocin for cervical ripening and induction of labor

作　　者：范翠芳[1] 张正娥[2] 明蕾[1] 陈建华[1] 

机构地区：[1]武汉大学人民医院妇产科,武汉430060 [2]华中科技大学荆州医院妇产科,湖北荆州434000

出　　处：《重庆医学》2012年第36期3820-3822,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(30640039)

摘　　要：目的探讨COOK双球囊促宫颈成熟并引产的有效性和安全性。方法采用回顾性对照研究方法,对收集的符合引产指征、单胎、头位孕足月的320例孕产妇进行分析。160例采用COOK球囊引产为研究组,160例采用小剂量缩宫素引产为对照组,对2组促宫颈成熟并引产的效果、分娩方式、妊娠结局及并发症进行比较分析。结果 320例引产指征中主要是过期妊娠、羊水过少、妊娠期高血压疾病等,研究组宫颈成熟率为100.00%,显著高于对照组79.38%(P<0.05);研究组阴道分娩成功率(81.25%)明显高于对照组65%,差异有统计学意义(P<0.05);研究组剖宫产率占18.75%,明显低于对照组35%,差异有统计学意义(P<0.05)。剖宫产指征依次是相对头盆不称:持续性枕横位(或后位)、活跃期梗阻、妊娠期高血压疾病。对母儿结局的影响差异无统计学意义(P>0.05)。研究组产钳助产4例,对照组2例,无显著差异。2组引产过程中发生并发症各3例(1.88%),差异无统计学意义(P>0.05)。研究组2例发生脐带脱垂,1例宫腔感染,对照组2例发生子宫过度刺激,1例胎盘早剥。结论 COOK双球囊促宫颈成熟并引产效果明显优于缩宫素,并未增加母婴的并发症。Objective The purpose of this study was to compare the safety and efficacy of COOK double balloon dilation and oxytocin for preinduction cervical ripening and labor induction.Methods A total of 320 patients with indications of labor,a singleton fetus in cephalic presentation,over 37 weeks′ gestation were recruited and analyzed by retrospective control analysis method.160 cases received low dose of oxytocin by an intravenous infusion as control group,while another 160 cases adopt COOK double balloon dilation for 12 h followed by an intravenous oxytocin infusion as study group.Then the maternal adverse reactions,mode of delivery and delivery outcome of the two groups were compared respectively.Results Maternal indications for induction of labor included postterm pregnancy,oligohydramnios,hypertensive disorders,et al.Compare the study group and the control group,there are significant difference in the Bishop′s score（100% and 79.38% respectively,P0.05）,the vaginal delivery rates（81.25% and 65% respectively,P0.05）and the caesarean delivery rates（18.75% and 35% respectively,P0.05）.Indications of the cesarean delivery include relative cephalopelvic disproportion,active phase obstruction and hypertensive disorders.There was no significant difference in the outcome of mother and child in the two groups.There were 4 and 2 cases of forceps delivery in the study group and the control group respectively,showing no significant difference.And 3 cases of complications during the induction of labor occurred in each group,both accounted for 1.88%.In addition,there were 2 cases of umbilical cord prolapse and 1 case of intrauterine infection in the study group,2 cases of uterine hyperstimulation and 1 case of placental abruption in the control group.Conclusion COOK double balloon dilation is better than intravenous infusion of oxytocin for cervical ripening and induction of labor without increasing any complications.

关 键 词：催产素 引产 剖宫产术 COOK双球囊 

分 类 号：R719.3[医药卫生—妇产科学]