Abstract: 【Abstract】 Objective To investigate the safety and validity of the double balloon catheter in term pregnancy women with uterine scar on labor induction. Methods From October 2016 to March 2018, the term pregnant women who took antenatal examination and delivered in the Department of Obstetrics, Chenggong Hospital Xiamen University and met the inclusion criteria were selected as the research object. 57 term pregnant women with immature cervix who had a previous cesarean section without contraindication of vaginal trials were selected as the scar group, 57 term pregnant women with nonuterine scar and immature cervix were randomly selected as the non-scar group in the same period. Both of them were used double balloon catheter to promote cervical ripening and induction of labor. The delivery methods, indications of operation, Bishop score of cervix before and after induced labor, the time of labor induction, duration of labor, postpartum vaginal bleeding of 24 h, birth weight of newborn, neonatal asphyxia and uterine rupture were compared between the two groups. The influencing factors of cesarean section after induced labor were analyzed. The statistical analysis was performed by t test, χ2 test or Fisherexact probability and Logistic regression analysis method. Results There was no statistical significance in Bishop score of cervix before and after induced labor, the time of labor induction and total labor duration between the two groups (P>0.05). The age of the scar group was older than that in the non-scar group with statistical significance [(33.8±4.0) vs (30.2±4.2) years old, t=-4.722, P< 0.05]. There was no statistical significance in 71.9% of vaginal delivery rate in the scar group and 78.9% of vaginal delivery rate in the non-scar group (P>0.05). There was no statistical significance in indications of operation between the two
groups (P>0.05). There was no statistical significance in postpartum vaginal bleeding of 24 h and birth weight of newborn between the two groups (P>0.05). Logistic regression analysis showed that high Bishop score of cervix after induced labor was protective factor for caesarean (OR=0.426, 95%CI: 0.234-0.765, P=0.005), and heavy birth weight was a risk factor for cesarean (OR=1.001, 95%CI: 1.001-1.004, P=0.033), the age of pregnant woman, gestational weeks and the scarred uterus were not a risk factor for caesarean. Conclusion Double balloon catheter can be applied in term pregnancy women with uterine scar on promoting cervical ripening and labor induction, which can reduce repeat cesarean section rate and without increase maternal and fetal adverse outcome.
孙瑞清 郑剑兰 刘景兮 张小琼 汪文雁 陈琼. 双球囊导管在瘢痕子宫足月妊娠中的应用[J]. 发育医学电子杂志, 2019, 7(3): 208-213.
SUN Rui-qing, ZHENG Jian-lan, LIU Jing-xi, ZHANG Xiao-qiong, WANG Wen-yan, CHEN Qiong. Application of double balloon catheter in term pregnancy women with cesarean scara. Journal of Developmental Medicine(Electronic Version), 2019, 7(3): 208-213.