足月妊娠引产促宫颈成熟的方法探讨  

Study of the proper methods used for cervical ripening and induced abortion in full-term pregnancy

作　　者：汪丽兰[1] 相媛媛[1] 陈宏霞[1] 王晓梅[1] 

机构地区：[1]中山大学附属中山市人民医院产科,广东中山528400

出　　处：《吉林医学》2015年第18期4021-4024,共4页Jilin Medical Journal

摘　　要：目的:为宫颈不成熟的足月妊娠引产探讨更适宜的方法。方法:将140例具备引产指征的宫颈不成熟(宫颈Bishop评分﹤6分)足月妊娠孕妇随机分组,其中COOK子宫颈扩张球囊组(Ⅰ组)50例,缩宫素组(Ⅱ组)40例,欣普贝生组(Ⅲ组)50例,比较三组孕产妇的促宫颈成熟的有效率、促宫颈成熟至临产时间、促宫颈成熟至分娩时间、总产程、计划分娩成功率及母婴并发症等情况。结果:Ⅰ组促宫颈成熟有效50例(100%),Ⅱ组有效21例(52.5%),Ⅲ组有效47例(94.0%),Ⅰ组、Ⅲ组与Ⅱ组相比,差异有统计学意义(P﹤0.01);Ⅰ组、Ⅲ组促宫颈成熟至临产时间,促宫颈成熟至分娩时间均短于Ⅱ组,差异有统计学意义(P﹤0.01),Ⅰ组、Ⅲ组总产程比Ⅱ组短,差异有统计学意义(P﹤0.05);Ⅰ组与Ⅲ组阴道分娩率相近,Ⅱ组阴道分娩率最低,剖宫产率最高,与Ⅰ组、Ⅲ组比较,差异有统计学意义(P﹤0.01);Ⅲ组发生宫缩过强过频最高,与Ⅰ组比较,差异有统计学意义(P﹤0.05),Ⅰ组宫缩过强、胎儿窘迫或羊水粪染、产后出血、软产道裂伤发生率最低;新生儿窒息仅Ⅲ组发生1例。结论:COOK子宫颈扩张球囊、欣普贝生均有明显的促宫颈成熟作用,在应用COOK子宫颈扩张球囊促宫颈成熟的基础上,联合催产素引产,用于宫颈不成熟足月妊娠引产,是一种安全、有效、快速的方法。Objective To study the proper methods used for cervical ripening and induced abortion in full - term pregnancy. Method One hundred and forty women at term who had Bishop score less 6 were divided into three groups randomly,50 cases in Cook Cer-vical Ripening Balloon group（group Ⅰ）,40 cases in oxytocin group（groupⅡ）,50 cases in dinoprostone group（groupⅢ）. the cervical by Bishop scoring,the time of labor starting,the time of labor,the total stage of labor,the success rate of induced abortion and the maternal and neonatal complications were compared among the three groups. Results The group Ⅰ cervical ripened was 50 cases（100% ）,the group Ⅱwas 21 cases（52. 5% ）,the group Ⅲ was 47 cases（94. 0% ）,the group Ⅰ、the group Ⅲ comparied with the group Ⅱ had statistical signifi-cance（P ﹤ 0. 01）;the time of labor starting and labor in group Ⅰ and group Ⅲ was significantly shorter than group Ⅱ,which had statisti-cal significance（P ﹤ 0. 01）;the total stage of labor in group I and group Ⅱ were shorter than group Ⅱ,which had statistical significance（P﹤ 0. 05）;the rate of vaginal deliwery in group Ⅰ was similar with group Ⅲ,then the rate of vaginal deliwery in group Ⅱ was the lowest and the caesarean rate was highest,which had statistical significance（P ﹤ 0. 01）;the overstimulation of uterine contraction occurred more fre-quently in groupⅢ,and compared with group Ⅰ,the difference was statisticaly significant（P ﹤ 0. 05）;the incidence of overstimulation of uterine contraction occurred、fetal distress or meconium arnniotic fluid、the postpartum hemorrhage 、trauma of birth canal in group Ⅰ were＆amp;nbsp;the lowest;there was only one case with neonatal asphyxia in group Ⅲ. Conclusion Cook Cervical Ripening Balloon and dinoprostone have the obvious effect on promoting cervical ripening,Based on the use of cook Cervical Ripening Balloon,with oxytocin,may be an effective 、safe and rapid cervical ripening agent in late pregnancy.

关 键 词：足月妊娠 促宫颈成熟 COOK 子宫颈扩张球囊 引产 

分 类 号：R719.3[医药卫生—妇产科学]