瘢痕子宫, 双球囊导管, 引产, 剖宫产," /> 瘢痕子宫, 双球囊导管, 引产, 剖宫产,"/> Scarred uterus, Double balloon catheter, Induction, Cesarean section,"/> <span style="line-height:2;font-size:14px;">双球囊导管在瘢痕子宫足月妊娠中的应用</span>
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发育医学电子杂志  2019, Vol. 7 Issue (3): 208-213    DOI: 10.3969/j.issn.2095-5340.2019.03.009
  围产医学   论著 |产科 |
双球囊导管在瘢痕子宫足月妊娠中的应用
孙瑞清 郑剑兰 刘景兮 张小琼 汪文雁 陈琼
厦门大学附属成功医院
Application of double balloon catheter in term pregnancy women with cesarean scara
SUN Rui-qing, ZHENG Jian-lan, LIU Jing-xi, ZHANG Xiao-qiong, WANG Wen-yan, CHEN Qiong
Chenggong Hospital Xiamen University
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摘要 【摘要】 目的  探讨双球囊导管在瘢痕子宫足月妊娠引产中的安全性和有效性。 方法 选取2016 年10 月至2018 年3 月在厦门大学附属成功医院产科产检及分娩,且符合纳入标准的孕产妇为研究对象,将既往有1 次子宫下段剖宫产史且无阴道试产禁忌证的57 例宫颈未成熟的足月孕产妇设为瘢痕组,另外随机选取同期57 例非瘢痕子宫、宫颈未成熟的足月妊娠孕产妇设为非瘢痕组。两组均用双球囊导管促宫颈成熟及引产,比较两组间的分娩方式、手术指征、引产前与引产后宫颈Bishop 评分、引产时间、产程时
间、产后24 h 的出血量、新生儿出生体质量、新生儿窒息和子宫破裂等,并分析引产后剖宫产的影响因素。采用t 检验、χ2 检验或Fisher 确切概率法、Logistic 回归分析法进行统计分析。 结果 两组孕产妇引产前与引产后宫颈Bishop 评分、引产时间及总产程比较差异无统计学意义(P>0.05);瘢痕组的年龄较非瘢痕组大,差异有统计学意义[(33.8±4.0)与(30.2±4.2)岁,t=-4.722,P<0.05]。瘢痕组阴道分娩率为71.9%,非瘢痕组为78.9%,两组比较差异无统计学意义(P>0.05)。两组手术指征比较,差异无统计学意义(P>0.05)。两组的产后24 h 出血量、新生儿出生体质量比较,差异无统计学意义(P>0.05)。Logistic 回归分析表明引产后宫颈Hishop 评分高是剖宫产的保护因素(OR=0.426,95%CI 为0.234 ~ 0.765,P=0.005),新生儿出生体质量大是剖
宫产的危险因素(OR=1.001,95%CI 为1.001 ~ 1.004,P=0.033),孕产妇年龄、孕周以及瘢痕子宫不是引产后剖宫产的危险因素。 结论 双球囊导管可用于瘢痕子宫足月妊娠孕产妇的促宫颈成熟及引产,降低再次剖宫产率,同时不增加母婴不良结局。
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关键词:  font-size:14px  瘢痕子宫')" href="#">">瘢痕子宫  双球囊导管  引产  剖宫产    
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.
Key words:  font-size:14px    Scarred uterus')" href="#">">Scarred uterus    Double balloon catheter    Induction    Cesarean section
收稿日期:  2019-03-19                出版日期:  2019-07-30      发布日期:  2019-07-26      期的出版日期:  2019-07-30
基金资助: 国家自然科学基金面上项目(81270718)
通讯作者:  郑剑兰    E-mail:  sunnyzdoc@163.com
引用本文:    
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.
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