COOK双球囊导管在足月妊娠引产中的临床研究

目的:探讨宫颈双球囊导管在足月妊娠促宫颈成熟及引产中的有效性和安全性。方法:回顾性选择符合有引产指征、单胎头位、宫颈评分6分的100例足月妊娠孕妇进行分析,其中51例采用COOK双球囊导管引产者为COOK组,49例采用小剂量缩宫素引产者为对照组,比较分析两组宫颈成熟度、引产效果、分娩方式、分娩结局、产后出血、新生儿窒息等情况。结果:100例孕妇引产指征主要是延期(过期)妊娠、羊水过少、妊娠期高血压、妊娠期糖尿病、妊娠合并甲减等。COOK组51例促宫颈成熟有效49例(96.08%),对照组有效16例(32.65%),COOK组促宫颈成熟有效率显著高于对照组,差异有统计学意义(P0.05)。COOK组诱发临产时间明显少于对照组,两组差异有统计学意义(P0.05)。COOK组阴道分娩41例(80.39%),剖宫产10例(19.61%);对照组阴道分娩20例(40.82%),剖宫产29例(59.18%),COOK组阴道分娩率明显高于对照组,剖宫产率明显低于对照组,两组差异均有统计学意义(P0.05)。两组之间的总产程、羊水污染率、新生儿窒息率、产后出血率等围产结局无显著差异(P0.05);COOK组引产过程中出现不良反应6例(11.76%),对照组5例(10.20%),两组无显著差异(P0.05)。结论:COOK双球囊导管促宫颈成熟及引产效果明显优于缩宫素,且不增加不良反应的发生,由于操作简单,有效性和安全性高,值得国内临床推广。

Clinical Study of COOK Double-balloon Catheter Application in Labour Induction for Full-termPregnancy

Objective:To investigate efficacy and safety of cervical double-balloon catheter in cervical ripening and full-term labour induction.Methods:100 full-term pregnant women, who met indications for labour induction (single cephalic, cervical score<6), were enrolled in a retrospective analysis. Among of them, 51 patients received labour induction with COOK double-balloon catheter (COOK group), while 49 patients received labour induction with a small dose of oxytocin (control group). Cervical ripening, efficacy, delivery mode, birth outcomes, and incidences of adverse reactions (postpartumhemorrhage, neonatal asphyxia, etc.) were compared.Results:The indications for labour induction of 100 pregnant women mainly included prolonged pregnancy, oligohydramnios, hypertension in pregnancy, gestational diabetes mellitus, gestation hypothyroidism, etc. In the COOK group, the double-balloon catheter were effective in 51 cases (96.68%) on cervical ripening, while oxytocin could only promote cervical ripening in 16 cases (32.65%) in the control group, the difference is statistically significant (P<0.05). The induced labour time of the COOK group was significantly less than that of the control group (P<0.05). There were 41 cases of vaginal delivery (80.39%) and10 cases of cesarean section (19.61%) in the COOK group. In the control group, the cases of vaginal delivery and cesarean section were 20 (40.82%) and 29 cases (59.18%), respectively. The percentage of vaginal delivery in the COOK group was significantly higher than that in the control group. Maternal and neonatal adverse outcomes, including duration, meconium rates, neonatal asphyxia, and postpartumhemorrhage rates were not significantly different between two groups (P>0.05). During the courses of labour induction, adverse reactions occurred in 6 cases (11.76%) in the COOK group, and 5 cases in the control group (10.20%), the difference was not statistically significant (P>0.05).Conclusion:The efficacy of COOK double- balloon catheter in promoting cervical ripening and full-term labour induction was better than oxytocin, and the catheter didn''t increase the risk of adverse reactions. Due to its simplicity in operation and high efficacy and safety, application of COOK double-balloon catheter in domestic clinic is suggested.