米非司酮联合宫颈球囊在孕晚期瘢痕子宫死胎引产中的应用  

Mifepristone Combined with Cervical Balloon in the Induction of Stillbirth in Keloid Uterus in Late Pregnancy

作　　者：丁慧 DING Hui(Obstetrics Department of Jiangxi Provincial Maternal and Child Health Care Hospital,Nanchang 330038,China)

机构地区：[1]江西省妇幼保健院产科,江西南昌330038

出　　处：《宜春学院学报》2023年第9期49-52,共4页Journal of Yichun University

基　　金：江西省卫生健康委科技计划项目(编号:20195494)。

摘　　要：目的:探究米非司酮联合宫颈球囊在孕晚期瘢痕子宫死胎引产中的应用。方法:回顾性选取我院收治的瘢痕子宫妊娠晚期胎死宫内且符合纳入标准需要引产患者40例作为研究对象,按照随机数字表法分为球囊组20例及联合组20例,分别给予宫颈Cook球囊及宫颈Cook球囊联合米非司酮治疗。分析米非司酮干预的临床效果。观察患者宫颈Bishop评分、阴道分娩率、剖宫取胎率、平均总产程、平均产后出血量(产后2小时内)及引产并发症(子宫破裂、感染等)等的变化。结果:联合组临床效果95.00%,相较于球囊组的临床效果65.00%明显升高(P<0.05)。取出球囊后,宫颈Bishop评分相较于引产前明显升高(P<0.05),且联合组宫颈Bishop评分显著高于球囊组(P<0.05)。与球囊组相对比,联合组孕产妇阴道分娩率明显升高(P<0.05),剖宫取胎率明显降低(P<0.05)。相较于球囊组,联合组孕产妇平均总产程显著缩短(P<0.05),平均产后出血量显著减少(P<0.05)。联合组引产并发症发生率5%,相较于球囊组引产并发症发生率30.00%显著降低(P<0.05)。结论:米非司酮联合宫颈球囊在孕晚期瘢痕子宫死胎引产中能够起到较好效果,能够有效降低剖宫产取胎率,增加阴道分娩率,安全性较高。Objective:To investigate the application of mifepristone combined with cervical balloon in the induction of stillbirth in late pregnancy with scarred uterus.Methods:Forty patients admitted to our hospital with keloid uterus who met the inclusion criteria of stillbirth in late pregnancy and needed to be induced were retrospectively selected and divided into 20 cases in the balloon group and 20 cases in the combined group according to the method of randomised numerical table,and were given the cervical Cook balloon and the cervical Cook balloon combined with mifepristone treatment,respectively.The clinical effects of mifepristone intervention were analysed.Changes in patients’cervical Bishop score,vaginal delivery rate,cesarean section retrieval rate,average total labour duration,average postpartum haemorrhage(within 2 hours after delivery)and complications of induced labour(uterine rupture,infection,etc.)were observed.Results:The clinical outcome of 95.00%in the combined group was significantly higher compared to 65.00%in the balloon group(P<0.05).After removal of the balloon,the cervical Bishop score was significantly higher compared to that before induction of labour(P<0.05),and the cervical Bishop score in the combined group was significantly higher than that in the balloon group(P<0.05).Compared with the balloon group,the rate of vaginal delivery was significantly higher in the combined group(P<0.05),and the rate of cesarean section was significantly lower(P<0.05).Compared with the balloon group,the average total labour duration of pregnant women in the combined group was significantly shorter(P<0.05),and the average postpartum haemorrhage was significantly reduced(P<0.05).The complication rate of induced labour in the combined group was 5%,which was significantly lower(P<0.05)compared to the balloon group with an induced labour complication rate of 30.00%.Conclusion:Mifepristone combined with cervical balloon can play a better effect in the induction of stillbirth in late pregnancy with keloid uterus,which

关 键 词：米非司酮 宫颈球囊 孕晚期 瘢痕子宫 死胎引产 

分 类 号：R719.3[医药卫生—妇产科学]