COOK球囊用于妊娠期高血压疾病产妇促宫颈成熟的有效性和安全性  

Effectiveness and safety of COOK balloon applied to promoting maturation of the uterine cervix in parturients with hypertensive disorder complicating pregnancy

作　　者：曹丽华 洪喜萍[1] 奚杰[1] CAO Li-hua;HONG Xi-ping;XI Jie(Department of Obstetrics,Shanghai Jiading District Maternal and Child Health Hospital,Shanghai 201821,China)

机构地区：[1]上海市嘉定区妇幼保健院产科,上海市201821

出　　处：《广西医学》2022年第9期930-936,共7页Guangxi Medical Journal

基　　金：上海市嘉定区医学重点专科(产科)(JDYXZDZK-8)。

摘　　要：目的观察COOK球囊用于妊娠期高血压疾病产妇促宫颈成熟的有效性和安全性。方法回顾性分析244例阴道试产的妊娠期高血压疾病产妇的临床资料,根据临床干预措施的不同分为COOK球囊组64例(入院时宫颈Bishop评分<6分)、人工破膜组73例(入院时宫颈Bishop评分≥6分)、自然临产组107例(入院时自然临产和胎膜早破),分别给予COOK球囊法促宫颈成熟后人工破膜引产、直接人工破膜术引产、催产素引产及自然临产。观察COOK球囊组产妇促宫颈成熟的效果。比较3组产妇的引产成功率、阴道分娩成功率、分娩方式、母婴并发症、住院情况,以及阴道分娩成功产妇的产程时间。结果(1)COOK球囊组产妇促宫颈成熟总有效率为96.88%(62/64)。(2)COOK球囊组与自然临产组的产妇引产成功率差异无统计学意义(P>0.05);3组产妇阴道分娩成功率差异无统计学意义(P>0.05)。(3)3组产妇未临产剖宫产率差异有统计学意义(P<0.05),人工破膜组未临产剖宫产率高于自然临产组(P<0.05);3组产妇临产剖宫产率、产钳助产、自然分娩率比较,差异均无统计学意义(均P>0.05)。(4)3组阴道分娩成功产妇的第一产程、第二产程、第三产程、总产程时间比较,差异均无统计学意义(均P>0.05)。(5)3组产妇分娩时平均动脉压(MAP),以及产后出血、胎儿宫内窘迫、新生儿窒息、新生儿入住ICU比例比较,差异均无统计学意义(均P>0.05);自然临产组产后2 h MAP高于人工破膜组,COOK球囊组住院费高于其他两组,住院时间长于自然临产组(均P<0.05);3组产妇均无其他严重母婴并发症发生。结论COOK球囊用于妊娠期高血压疾病产妇促宫颈成熟有效、安全。Objective To observe the effectiveness and safety of COOK balloon applied to promoting maturation of the uterine cervix in parturients with hypertensive disorder complicating pregnancy.Methods The clinical data of 244 parturients with hypertensive disorder complicating pregnancy who attempted to undertake transvaginal delivery were analyzed retrospectively.According to the clinical intervention measures,they were divided into COOK balloon group(64 cases with cervical Bishop scores<6 on admission),artificial rupture of membranes group(73 cases with cervical Bishop scores≥6 on admission),natural parturition group(107 cases of natural parturition and premature rupture of membranes on admission).The three groups of parturients were given induced labor of artificial rupture of membranes following promoting maturation of the uterine cervix by COOK balloon procedures,induction of labor by direct artificial rupture of membranes,induction of labor by oxytocin,as well as natural parturition,respectively.The effect of promoting maturation of the uterine cervix was observed in the parturients of the COOK balloon group;moreover,the success rate of induction of labor,success rate of transvaginal labor,delivery mode,maternal and neonatal complications,conditions of hospitalization,and the length of labor stage of parturients with successful transvaginal labor of the parturients were compared between the three groups.Results(1)The total effective rate for promoting maturation of the uterine cervix in the COOK balloon group was 96.88%(62/64).(2)No statistically significant difference was found in the success rate of induction of labor among the three groups(all P>0.05),and there was no statistically significant difference in the success rate of transvaginal labor among the three groups(P>0.05).(3)There was a statistically significant difference in the rate of cesarean section in the absence of labor among the three groups(P<0.05),and the artificial rupture of membranes group exhibited a higher rate of cesarean section in the ab

关 键 词：妊娠期高血压疾病 COOK球囊 宫颈成熟 BISHOP评分 分娩方式 母婴结局 

分 类 号：R714.25[医药卫生—妇产科学]