足月妊娠产妇宫颈COOK球囊引产结局及影响因素分析

doi:10.3760/cma.j.issn.1007-1245.2024.19.015

摘要/Abstract

摘要：

目的　探讨足月妊娠产妇应用宫颈COOK球囊引产的结局，分析相关影响因素。方法　采用回顾性分析，选取咸阳市妇幼保健院2021年1月至2023年10月收治的196例足月妊娠产妇，均采用宫颈COOK球囊进行引产。产妇年龄（29.48±4.61）岁，体重指数（BMI）（26.52±1.86）kg/m²，球囊放置前宫颈Bishop评分（4.03±0.46）分。根据引产结局将产妇分为引产成功组和引产失败组，分析影响引产结局的因素。组间比较采用独立样本t检验、χ²检验，影响因素采用二元logistic回归分析，引产结局预测价值采用受试者操作特征曲线（ROC）进行评估。结果　196例足月妊娠产妇中，引产成功145例，引产失败51例（产钳助产10例，药物辅助引产9例，剖腹产32例）；引产失败组年龄、新生儿体重及产前BMI>25 kg/m²、初产、球囊放置时间>12 h占比均高于引产成功组（均P<0.05），Bishop评分低于引产成功组（P<0.05），两组孕周、并发症、引产指征、胎膜早破比较，差异均无统计学意义（均P>0.05）。多因素logistic回归分析显示，年龄增长、产前BMI>25 kg/m²、初产、新生儿体重增加是影响引产失败的危险因素（均P<0.05），Bishop评分升高为引产成功的有利因素（P<0.05），预测足月妊娠产妇应用宫颈COOK球囊引产失败的曲线下面积为0.812，灵敏度为72.55%，特异度为75.17%。结论　足月妊娠产妇应用宫颈COOK球囊引产具有一定的引产失败风险，其中年龄升高、产前BMI>25 kg/m²、初产、新生儿体重升高是足月妊娠产妇引产失败的危险因素。

关键词:

引产, COOK球囊, 足月妊娠, 影响因素, 预测价值

Abstract:

Objective　To explore the outcomes of cervical COOK balloon induced labor in puerperae with full-term pregnancy and to analyze the related influencing factors. Methods　The data of 196 puerperae with full-term pregnancy treated at Xianyang Maternal and Child Health Hospital were retrospectively analyzed. They were (29.48±4.61) years old. Their body mass index (BMI) was (26.52±1.86) kg/m². Their cervical Bishop score before placing the balloons was (4.03±0.46). All the patients were induced by cervical COOK balloons. According to the induced labor outcomes, the puerperae were divided into a successful induced labor group and a failed induced labor group. The factors affecting the induced labor outcomes were analyzed. The data were compared between the two groups by the independent-sample t test and χ² test. The influencing factors were analyzed by bivariate logistic regression analysis. The receiver operating characteristic curve (ROC) was used to analyze the value on predicting their pregnancy outcomes. Results　Among the 196 puerperae, there were 145 cases of successful induced labor and 51 cases of failed induced labor, including 10 cases of forceps delivery, 9 cases of drug-assisted induced induction, and 32 cases of cesarean section. The age, neonatal weight, proportions of the women with prenatal BMI>25 kg/m², primiparity, and balloon placement time>12 h in the failed induced labor group were higher than those in the successful induced labor group (all P<0.05), while the Bishop score was significantly lower than that in the successful induced labor group (P<0.05). There were no statistical differences in gestational age, complications, indications for induction of labor, and proportion of the women with premature rupture of membranes between the two groups (all P>0.05). The multivariate logistic regression analysis showed that increased age, prenatal BMI>25 kg/m², primiparity, and elevated neonatal weight were the risk factors for failed induced labor in the puerperae (all P<0.05), and the increase of Bishop score was the favorable factor for successful induced labor (P<0.05). The ROC analysis revealed that the area under the curve, sensitivity, and specificity of the above factors in predicting the failed induced labor by cervical COOK balloons in the puerperae were 0.812, 72.55%, and 75.17%, respectively. Conclusions　For puerperae with full-term pregnancy, the application of cervical COOK balloon induced labor has a certain risk of induced labor failure. Increased age, proportion of prenatal BMI>25 kg/m², primiparity, and neonatal weight increase are risk factors for induced labor failure in puerperae with full-term pregnancy.

Key words:

Induced labor, COOK balloon, Puerperae with full-term pregnancy, Influencing factors, Predictive value

李海英门亚萍贺译平.

足月妊娠产妇宫颈COOK球囊引产结局及影响因素分析 [J]. 国际医药卫生导报, 2024, 30(19): 3240-3244.

Li Haiying, Men Yaping, He Yiping.

Cervical COOK balloon induced labor outcomes and related influencing factors in puerperae with full-term pregnancy [J]. International Medicine and Health Guidance News, 2024, 30(19): 3240-3244.

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