摘要
目的探讨宫颈COOK球囊应用于足月妊娠引产的临床效果及其影响因素。方法回顾性分析2019年6月至2020年12月在北京市通州区妇幼保健院采用宫颈COOK扩张球囊引产的315例足月妊娠孕妇的临床资料,观察球囊使用过程中的不良反应及母儿结局,对孕妇的各项指标进行Logistic回归分析,观察其对引产效果的影响,并由此建立回归模型预测引产效果。结果315例孕妇在使用宫颈球囊过程中发生不良反应共6例(1.90%),阴道分娩共221例(70.16%)纳入自娩组,其中阴道助产共38例(12.06%);剖宫产共94例(29.84%)纳入剖宫产组。发生母体产后并发症者19例(6.03%),新生儿转新生儿重症监护室24例(7.62%)。进行单因素分析发现两组间孕妇产次、体质量指数(BMI)、引产前Bishop评分及新生儿体重存在显著性差异(P<0.05);进行多因素回归分析发现,孕妇产次及引产前宫颈Bishop评分与引产成功呈正相关,而孕前BMI及新生儿体重与引产成功呈负相关(P<0.05),并得出回归方程。绘制受试者工作特征(ROC)曲线,其曲线下面积(AUC)为0.856(95%CI:0.795-0.918),回归方程预测引产效果的阳性预测值为75.0%,阴性预测值为74.6%,准确度为74.9%。结论孕妇产次、孕前BMI、引产前宫颈Bishop评分及新生儿体重可作为球囊引产效果的预测指标。
Objective:To investigate the clinical effect and influencing factors of Cook cervical balloon on induction of labor in full-term.Methods:The data of 315 full-term pregnant women who were induced by Cook cervical dilation balloon in Tongzhou Maternal and Child Health Hospital from June 2019 to December 2020 were retrospectively analyzed.The adverse reactions,maternal and fetal outcomes during the use of balloon were observed.The indexes of pregnant women were analyzed by logistic regression to observe their impact on the effect of induction of labor.A regression model was established to predict the effect of induced labor.Results:There were 6 cases(1.90%)of adverse reactions in 315 pregnant women during the use of cervical balloon and 221 cases(70.16%)of vaginal delivery(vaginal delivery group),including 38 cases(12.06%)of vaginal midwifery,94 cases(29.84%)of cesarean section(cesarean section group),19 cases(6.03%)of maternal postpartum complications and 24 cases(7.62%)of neonatal transfer to neonatal intensive care unit(NICU).Univariate analysis showed that there were significant differences in parity,body mass index(BMI),Bishop score before induced labor and neonatal weight between the two groups(P<0.05).Multivariate regression analysis found that parity and cervical Bishop score before pregnancy were positively correlated with the success of induced labor,while BMI before pregnancy and neonatal weight were negatively correlated with the success of induced labor,and the regression equation was obtained.The receiver operation characteristic(ROC)curve was drawn.The area under the curve was 0.856(95%CI:0.795-0.918).The positive predictive value of regression equation for predicting the effect of induced labor was 75.0%,the negative predictive value was 74.6%,and the accuracy was 74.9%.Conclusions:Parity,BMI before pregnancy,cervical Bishop score and neonatal weight can be used as predictors of the effect of balloon induction of labor.
作者
杨莉
王曼
李楠
苏涛
周丽
李小庆
YANG Li;WANG Man;LI Nan;SU Tao;ZHOU Li;LI Xiao-qing(Tongzhou Maternal&Child Health Hospital of Beijing,Beijing 101100)
出处
《生殖医学杂志》
CAS
2022年第2期208-213,共6页
Journal of Reproductive Medicine
基金
北京市通州区科学技术基金(KJ2020CX011)。
关键词
子宫颈扩张球囊
不良反应
妊娠结局
引产
影响因素
Cervical dilation balloon
Adverse reactions
Pregnancy outcome
Induction of labor
Influencing factors
