宫颈Bishop评分与地诺前列酮计划分娩效果的临床观察

目的:探讨宫颈Bishop评分与地诺前列酮(欣普贝生)用于足月妊娠计划分娩临床效果和母婴安全的相关性。方法:选择181例足月妊娠、宫颈Bishop评分≤6分、有阴道分娩适应证、无计划分娩禁忌证、无严重内科合并症的单胎头位孕妇,初始给予地诺前列酮阴道栓1枚促宫颈成熟,如未动产给予缩宫素静滴。分别以宫颈初始评分及地诺前列酮用药后宫颈评分改变分组,比较宫颈Bishop评分、宫缩、用药到临产时间、分娩情况、阴道分娩率、对胎儿及新生儿的影响及产后出血。结果:宫颈初始评分高分组较低分组欣普贝生计划分娩成功率及阴道分娩率高,差异有统计学意义(P<0.05)。地诺前列酮用药后宫颈评分改变高组缩宫素计划分娩时计划分娩成功率及阴道分娩率较高,与宫颈评分改变低组差异有统计学意义(P<0.05)。低宫颈评分组及改变组羊水污染率及新生儿窒息率较高(P<0.05)。结论:宫颈Bishop评分与地诺前列酮计划分娩效果紧密相关;计划分娩需加强监护,及时发现异常情况并加以处理。

Clinical observation on cervical Bishop score and the effect of dinoprostone for programed delivery

Objective:To explore cervical Bishop score,clinical efficacy of dinoprostone used for programed delivery of full term pregnancy,and the correlation with maternal and infantile safety.Methods:A total of 181 full term pregnant women(cervical Bishop score≤6,with indications of vaginal delivery,without contraindications of programed delivery,without severe medical complications,single pregnancy,head position) were selected,then they were treated with placing dinoprostone vaginal suppository into vagina to promote cervical repining,intravenous drip of oxytocin was applied if failed.All the pregnant women were divided into different groups according to initial cervical Bishop score and cervical scores before and after treatment with dinoprostone.The cervical Bishop scores,the degrees of uterine contraction,the interval times from treatment to in labor,the conditions of delivery,vaginal delivery rates,the effects on fetuses and neonates,and the amounts of postpartum hemorrhage in different groups were compared.Results:The successful rate of programed delivery and vaginal delivery rate in high initial cervical Bishop score group were statistically significantly higher than those in low initial cervical Bishop score group(P<0.05).The successful rate of programed delivery and vaginal delivery rate in the pregnant women with large change of cervical Bishop score before and after treatment with dinoprostone were statistically significantly higher than those in the pregnant women with small change of cervical Bishop score before and after treatment with dinoprostone(P<0.05).The incidences of amniotic fluid pollution and neonatal asphyxia in low initial cervical Bishop score group and the pregnant women with small change of cervical Bishop score before and after treatment with dinoprostone were statistically significantly higher than those in high initial cervical Bishop score group and the pregnant women with large change of cervical Bishop score before and after treatment with dinoprostone(P<0.05).Conclusion:Cervical Bishop score was closely related to the efficacy of programed delivery of dinoprostone;monitoring should be strengthened during programed delivery,the abnormal conditions should be detected and treated timely.