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双球囊联合缩宫素用于引产:影响宫颈成熟疗效的多因素分析

Double Balloon Combined with Oxytocin in Labor Induction: Analysis of Multivariate Factors Affecting the Efficacy of Cervical Ripening.

作者信息

Wu Xian-Lin, Liu Hong-Yan, Xiang Qiu-Hong, Yin Zhuan, Zhou Rong, Wang Ye-Juan, Zhou Bi-Yu, Wang Fang, Zhao Min, Chen Mei

机构信息

Department of Obstetrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 410007, People's Republic of China.

Department of Nursing, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 410007, People's Republic of China.

出版信息

Int J Womens Health. 2024 Jul 5;16:1219-1227. doi: 10.2147/IJWH.S460853. eCollection 2024.

Abstract

OBJECTIVE

Labor induction during the late trimester of pregnancy is a common option of terminating pregnancy by inducing uterine contractions through medication or cervical mechanical dilation. However, there are few researches on the factors influencing the effectiveness of cervical ripening balloon combined with oxytocin in inducing labor. To explore factors affecting the efficacy of cervical ripening double balloon combined with oxytocin in labor induction.

METHODS

Using a convenient sampling method, this study retrospectively collected the clinical data of 230 pregnant women who underwent cervical ripening double balloon combined with oxytocin for labor induction in our hospital from September 2021 to August 2022. The included subjects were divided into a vaginal delivery group (n = 180) and a cesarean section group (n = 50) based on the delivery mode for comparing relevant indicators between the two groups.

RESULTS

The presence of acute chorioamnionitis ( = 1.456, : 1.257-2.112), fetal distress ( = 1.371, : 1.331-2.633), and the placement of cervical ripening balloon catheter for >12h ( = 1.563, : 1.231-3.263) were risk factors for successful application of cervical ripening double balloon combined with oxytocin for labor induction in pregnant women; while multi-gravidity ( = 0.736, : 0.455-0.875) was a protective factor. In addition, evaluation of the predictive value revealed that acute chorioamnionitis, fetal distress, the placement of cervical ripening balloon catheter for >12h, and gravidity all had certain predictive value for the failure of cervical ripening double balloon combined with oxytocin for labor induction, with the highest predictive value found through joint predictive (AUC: 0.931, 95% CI: 0.714-0.811).

CONCLUSION

Cervical ripening double balloon combined with oxytocin for labor induction may have a high success rate in multigravida. Acute chorioamnionitis, fetal distress, and prolonged placement of the balloon may have a negative impact on the success rate of cervical ripening double balloon combined with oxytocin for labor induction.

摘要

目的

妊娠晚期引产是通过药物或宫颈机械扩张诱导子宫收缩来终止妊娠的常见选择。然而,关于宫颈成熟球囊联合缩宫素引产效果的影响因素研究较少。旨在探讨影响宫颈成熟双球囊联合缩宫素引产效果的因素。

方法

本研究采用方便抽样法,回顾性收集了2021年9月至2022年8月在我院接受宫颈成熟双球囊联合缩宫素引产的230例孕妇的临床资料。根据分娩方式将纳入对象分为阴道分娩组(n = 180)和剖宫产组(n = 50),比较两组的相关指标。

结果

急性绒毛膜羊膜炎( = 1.456, :1.257 - 2.112)、胎儿窘迫( = 1.371, :1.331 - 2.633)以及宫颈成熟球囊导管放置时间>12小时( = 1.563, :1.231 - 3.263)是孕妇宫颈成熟双球囊联合缩宫素引产成功应用的危险因素;而经产妇( = 0.736, :0.455 - 0.875)是保护因素。此外,预测价值评估显示,急性绒毛膜羊膜炎、胎儿窘迫、宫颈成熟球囊导管放置时间>12小时以及产次对宫颈成熟双球囊联合缩宫素引产失败均有一定的预测价值,联合预测的预测价值最高(AUC:0.931,95%CI:0.714 - 0.811)。

结论

宫颈成熟双球囊联合缩宫素引产在经产妇中可能有较高的成功率。急性绒毛膜羊膜炎、胎儿窘迫以及球囊放置时间延长可能对宫颈成熟双球囊联合缩宫素引产的成功率产生负面影响。

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