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目的:探讨宫颈扩张球囊(COOK球囊)和前列腺素(欣普贝生)用于孕足月宫颈条件不成熟孕妇引产的有效性和安全性。方法:回顾分析2012年10月至2013年10月同济大学上海市第一妇婴保健院收治的宫颈Bishop评分<6分并使用COOK球囊或欣普贝生引产的足月孕产妇的临床资料。分析两种方法的促宫颈成熟效果、引产效果,并对子宫过度刺激、胎儿窘迫、新生儿窒息等安全性进行比较。结果:COOK球囊组和欣普贝生组的分娩方式无明显差异(阴道分娩率:73.7%vs 72.0%,P=0.62)。两种引产方式自引产至分娩时间间隔比较,差异无统计学差异,但COOK球囊组24h内的阴道分娩率明显低于欣普贝生组(37.9%vs 48.5%,P=0.007)。研究中6例疤痕子宫产妇采用COOK球囊引产,其中5例产妇顺利经阴道分娩,无分娩并发症。COOK球囊组和欣普贝生组的孕产妇、新生儿结局及并发症比较,差异无统计学意义(P>0.05)。结论:对足月宫颈条件不成熟孕妇采用宫颈扩张球囊引产,可有效促进患者的宫颈成熟,安全性高且能有效提高引产的成功率,尤其适用于合并疤痕子宫及胎儿宫内窘迫可能的孕产妇,而前列腺素引产更易导致子宫过度刺激,引起相关并发症。
Objective: To investigate the effectiveness and safety of cervical dilatation balloon (COOK balloon) and prostaglandin (Xin P bei sheng) for induction of labor in pregnant women with immature cervical pregnancy. Methods: The clinical data of full-term pregnant women with cervical Bishop score <6 and using COOK balloon or shengbuobei were retrospectively analyzed from October 2012 to October 2013 in Tongji University Shanghai First Maternal and Child Health Care Hospital . Analysis of two methods of promoting cervical maturation effect, induction of labor effects, and uterine over stimulation, fetal distress, neonatal asphyxia and other safety were compared. RESULTS: There was no significant difference in delivery between the COOK balloon group and the enxapram group (vaginal delivery: 73.7% vs 72.0%, P = 0.62). There was no significant difference in induction of labor between labor induction and delivery, but the vaginal delivery rate in COOK balloon group was significantly lower than that in the Xinpobei group (37.9% vs 48.5%, P = 0.007). Six cases of scar maternal uterus using COOK balloon abortion, of which 5 maternal smooth vaginal delivery, no complications of childbirth. There were no significant differences in maternal, neonatal outcomes and complications between the COOK balloon group and the hippocampus group (P> 0.05). Conclusion: Cervical dilatation of the abdomen induced by full-term cervical conditions in pregnant women can effectively promote the cervical ripening of patients with high safety and can effectively improve the success rate of induction of labor, especially for the combination of scar uterus and fetal distress possible Maternal, and prostaglandin induced labor more likely to lead to excessive uterine stimulation, causing complications.