3种计划分娩方式在晚期妊娠计划分娩中的效果及安全性分析
|
摘要
目的探讨地诺前列酮栓、一次性球囊宫颈扩张器、缩宫素在晚期妊娠计划分娩孕产妇中的效果及安全性,为临床计划分娩提供参考依据。方法选取2015年1月-2017年6月在东阳市妇幼保健院产科住院计划分娩的足月孕产妇150例作为研究对象,根据计划分娩方式的不同将其分为A组(地诺前列酮栓组),B组(一次性球囊宫颈扩张器组),C组(缩宫素组),各50例。比较3组孕产妇促宫颈成熟有效率、宫颈Bishop评分、用药至临产时间、总产程时间、分娩方式(阴道分娩、剖宫产)、宫颈裂伤、宫缩过强、产后出血量及新生儿结局(新生儿体质量、1 min Apgar评分、窒息数)。结果 A组和B组在促宫颈成熟总有效率、给药后宫颈Bishop评分、用药至临产时间、总产程时间、分娩方式(阴道分娩率、剖宫产率)上优于C组,差异有统计学意义(均P<0. 05)。3组孕产妇在促宫颈成熟前宫颈Bishop评分、产后出血量、宫颈裂伤数及新生儿结局方面比较,差异无统计学意义(均P>0. 05)。A组宫缩过强发生率高于B组和C组,差异有统计学意义(均P<0. 05)。结论地诺前列酮栓和一次性球囊宫颈扩张器计划分娩效果优于单纯使用缩宫素,但需警惕地诺前列酮栓使用过程中宫缩过强。
Objective To explore the efficacies and safeties of dinoprostone suppository,disposable balloon cervical dilator,and oxytocin in programed delivery of late pregnancy,provide a reference basis for clinical programed delivery. Methods A total of 150 full-term pregnant women of programed delivery were selected from Department of Obstetrics in Dongyang Maternal and Child Health Care Hospital from January 2015 to June 2017,then they were divided into A group (dinoprostone suppository group),B group (disposable balloon cervical dilator),and C group (oxytocin) according to programed delivery modes,50 pregnant women in each group. The effective rates of cervical ripening,cervical Bishop scores,the time from medication to labor,the total labor time,delivery modes (vaginal delivery,cesarean section),cervical laceration,strong uterine contraction,the amounts of postpartum hemorrhage,and neonatal outcomes (birth weight,one-minute Apger score,the number of asphyxia) in the three groups were compared. Results The total effective rates of cervical ripening,cervical Bishop scores after administration,the time from medication to labor,the total labor time,delivery modes (vaginal delivery rate,cesarean section rate) in A group and B group were statistically significantly better than those in C group (P<0. 05). There was no statistically significant difference in cervical Bishop score before administration,the amount of postpartum hemorrhage,the number of cervical laceration,and neonatal outcomes among the three groups (P>0. 05). The incidence rate of strong uterine contraction in A group was statistically significantly higher than those in B group and C group (P<0. 05). Conclusion The effects of dinoprostone suppository and disposable balloon cervical dilator for programed delivery are superior to oxytocin alone,but strong uterine contraction in the course of use of dinoprostone suppository should be alerted.
Objective To explore the efficacies and safeties of dinoprostone suppository,disposable balloon cervical dilator,and oxytocin in programed delivery of late pregnancy,provide a reference basis for clinical programed delivery. Methods A total of 150 full-term pregnant women of programed delivery were selected from Department of Obstetrics in Dongyang Maternal and Child Health Care Hospital from January 2015 to June 2017,then they were divided into A group (dinoprostone suppository group),B group (disposable balloon cervical dilator),and C group (oxytocin) according to programed delivery modes,50 pregnant women in each group. The effective rates of cervical ripening,cervical Bishop scores,the time from medication to labor,the total labor time,delivery modes (vaginal delivery,cesarean section),cervical laceration,strong uterine contraction,the amounts of postpartum hemorrhage,and neonatal outcomes (birth weight,one-minute Apger score,the number of asphyxia) in the three groups were compared. Results The total effective rates of cervical ripening,cervical Bishop scores after administration,the time from medication to labor,the total labor time,delivery modes (vaginal delivery rate,cesarean section rate) in A group and B group were statistically significantly better than those in C group (P<0. 05). There was no statistically significant difference in cervical Bishop score before administration,the amount of postpartum hemorrhage,the number of cervical laceration,and neonatal outcomes among the three groups (P>0. 05). The incidence rate of strong uterine contraction in A group was statistically significantly higher than those in B group and C group (P<0. 05). Conclusion The effects of dinoprostone suppository and disposable balloon cervical dilator for programed delivery are superior to oxytocin alone,but strong uterine contraction in the course of use of dinoprostone suppository should be alerted.
引文
[1]Laughon SK,Zhang J,Grewal J,et al.Induction of labor in a contemporary obstetric cohort[J].Am J Obstet Gynecol,2012,206(6):486.e1-9.
[2]于晓霞,李彩霞.米索前列醇在孕足月妊娠促宫颈成熟的效果观察[J].中国医药指南,2013,11(15):219-220.
[3]中华医学会妇产科学分会产科学组.妊娠晚期促子宫颈成熟与引产指南(2014)[J].中华妇产科杂志,2014,49(12):881-885.
[4]汪文雁.妊娠晚期两种促宫颈成熟及引产方法的比较性研究[D].安徽医科大学,2013.
[5]戴钟英.提高阴道分娩安全性有效降低剖宫产率[J].中国实用妇科与产科杂志,2012,28(2):81-84.
[6]翁碧芬,李筱芸,余艳萍,等.宫颈球囊、欣普贝生及催产素引产对母婴结局的影响[J].海南医学,2017,28(3):414-416.
[7]韦玉华.妊娠晚期三种促宫颈成熟方法的疗效观察[J].贵阳中医学院学报,2013,35(3):149-151.
[8]吴如红,赵珊,黄洁容,等.地诺前列酮栓应用于妊娠晚期引产的效果观察及护理[J].中国临床护理,2014,6(2):128-130.
[9]郁玲珏,于淼淼.一次性宫颈球囊扩张器在足月妊娠促宫颈成熟及引产中的临床应用价值[J].中国性科学,2017,26(4):128-131.
[10]袁凤琼,袁筑华.静脉滴注缩宫素催产引产150例护理体会[J].贵州医药,2013,37(12):1151-1152.
[11]许晓艳,伊咏.妊娠晚期不同方法引产的临床研究[J].中国妇幼保健,2014,29(36):5979-5981.
[12]何秋.足月妊娠引产应用不同方法对促宫颈成熟的预后效果分析[J].中国计划生育和妇产科,2016,23(4):62-64,66.
[13]高霞,张毅,李咏梅.足月妊娠三种引产方法的临床对比分析[J].湖北医药学院学报,2015,34(2):139-143.
[14]沈梅,孙波,赵卫华,等.Cook子宫颈扩张球囊与欣普贝生用于足月妊娠引产的临床研究[J].中国妇幼保健,2015,30(4):624-627.
[15]陆巍.足月妊娠促宫颈成熟引产中控释地诺前列酮栓和缩宫素的效果比较[J].中国继续医学教育,2017,9(14):203-204.
[16]邱春女,方绮蓝.双球囊扩张、欣普贝生及催产素促宫颈成熟的临床对比观察[J].深圳中西医结合杂志,2016,26(15):99-101.
[2]于晓霞,李彩霞.米索前列醇在孕足月妊娠促宫颈成熟的效果观察[J].中国医药指南,2013,11(15):219-220.
[3]中华医学会妇产科学分会产科学组.妊娠晚期促子宫颈成熟与引产指南(2014)[J].中华妇产科杂志,2014,49(12):881-885.
[4]汪文雁.妊娠晚期两种促宫颈成熟及引产方法的比较性研究[D].安徽医科大学,2013.
[5]戴钟英.提高阴道分娩安全性有效降低剖宫产率[J].中国实用妇科与产科杂志,2012,28(2):81-84.
[6]翁碧芬,李筱芸,余艳萍,等.宫颈球囊、欣普贝生及催产素引产对母婴结局的影响[J].海南医学,2017,28(3):414-416.
[7]韦玉华.妊娠晚期三种促宫颈成熟方法的疗效观察[J].贵阳中医学院学报,2013,35(3):149-151.
[8]吴如红,赵珊,黄洁容,等.地诺前列酮栓应用于妊娠晚期引产的效果观察及护理[J].中国临床护理,2014,6(2):128-130.
[9]郁玲珏,于淼淼.一次性宫颈球囊扩张器在足月妊娠促宫颈成熟及引产中的临床应用价值[J].中国性科学,2017,26(4):128-131.
[10]袁凤琼,袁筑华.静脉滴注缩宫素催产引产150例护理体会[J].贵州医药,2013,37(12):1151-1152.
[11]许晓艳,伊咏.妊娠晚期不同方法引产的临床研究[J].中国妇幼保健,2014,29(36):5979-5981.
[12]何秋.足月妊娠引产应用不同方法对促宫颈成熟的预后效果分析[J].中国计划生育和妇产科,2016,23(4):62-64,66.
[13]高霞,张毅,李咏梅.足月妊娠三种引产方法的临床对比分析[J].湖北医药学院学报,2015,34(2):139-143.
[14]沈梅,孙波,赵卫华,等.Cook子宫颈扩张球囊与欣普贝生用于足月妊娠引产的临床研究[J].中国妇幼保健,2015,30(4):624-627.
[15]陆巍.足月妊娠促宫颈成熟引产中控释地诺前列酮栓和缩宫素的效果比较[J].中国继续医学教育,2017,9(14):203-204.
[16]邱春女,方绮蓝.双球囊扩张、欣普贝生及催产素促宫颈成熟的临床对比观察[J].深圳中西医结合杂志,2016,26(15):99-101.