COOK球囊联合缩宫素用于足月妊娠引产效果的预测指标分析

摘要

目的 探讨COOK球囊联合缩宫素用于足月妊娠引产效果的影响因素.方法 收集使用COOK促宫颈成熟双球囊导管(球囊)联合缩宫素引产的416例产妇,按引产效果分为引产成功组与引产失败组,记录2组产妇放置COOK球囊前及拔出COOK球囊后的宫颈Bishop评分,收集2组产妇的临床资料,分析COOK球囊联合缩宫素用于足月妊娠引产效果的预测指标.结果 416例产妇中,引产成功323例,引产失败93例,COOK球囊联合缩宫素引产成功率为78％ (323/416).放置COOK球囊前,2组产妇的宫颈Bishop评分比较差异无统计学意义(P＞0.05).拔出COOK球囊后,2组产妇的宫颈Bishop评分均高于放置前(P均＜0.05),其中引产成功组的宫颈Bishop评分高于引产失败组(P＜0.05).与引产失败组比较,引产成功组产妇经产妇及身高＞155 cm者比例较高(P均＜0.05).因延期妊娠、羊水过少、妊娠期糖尿病、妊娠期肝内胆汁淤积症、胎儿宫内生长受限者使用COOK球囊联合缩宫素引产的成功率均大于75％,而因妊娠期高血压疾病引产者的成功率为38％,因胎儿宫内窘迫引产者4例,无一成功.结论 COOK球囊联合缩宫素可有效促进足月妊娠产妇的宫颈成熟、促进产程,经产妇、身高及引产指征为预测COOK球囊联合缩宫素引产效果的有效指标.%Objective To identify the influencing factors of the effect of COOK balloon in combination with oxytocin upon induced labor in full-term pregnant women.Methods Clinical data of 416 pregnant women who received induced labor using COOK balloon in combination with oxytocin were collected.According to the effect of induced labor,all women were divided into the success and failure groups.The Bishop scores before and after COOK balloon placement were recorded in two groups.The influencing factors of the effect of COOK balloon combined with oxytocin upon the induced labor in full-term pregnant women were identified.Results Among 416 pregnant women,induced labor was successfully performed in 323 cases and failed in 93.The success rate of induced labor by COOK balloon in combination with oxytocin was 78％ (323/416).Prior to COOK balloon placement,no statistical significance was identified in the Bishop score between two groups (P ＞ 0.05).Mter removal of COOK balloon,the Bishop scores in two groups were significantly increased (both P ＜ 0.05).The Bishop score in the success group was considerably higher than that in the failure group (P ＜ 0.05).Compared with the failure group,the percentage of multiparous pregnant women and height ＞ 155 cm was significantly higher in the success group (both P ＜ 0.05).The success rate of induced labor in pregnant women receiving COOK balloon in combination with oxytocin due to delayed pregnancy,oligohydramnios,gestational diabetes mellitus and use of intrahepatic cholestasis during pregnancy and fetal intrauterine growth restriction exceeded 75％,and was only 38％ for those receiving induced labor due to gestational hypertension.The induced labor was not successfully performed in four women due to fetal distress in uterus.Conclusions COOK balloon in combination with oxytocin can effectively promote cervical maturation and accelerate course of labor.Multipara,height and induced labor-related indications are effective predictors for the effect of COOK balloon combined with oxytocin.