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在之前一次剖腹产后,每三小时拉动福利导管气球来诱导分娩:一项随机对照试验
Krishnan Yunesh1, Aizura Syafinaz Ahmad Adlan1, Thai Ying Wong1
1Faculty of Medicine, Department of Obstetrics and Gynecology, University of Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia.
American journal of obstetrics & gynecology MFM
|December 14, 2024
概括
在之前的剖腹产后,在分娩诱导期间,每3小时拉一根福利气球导管,并没有缩短分娩的时间,也没有提高患者的满意度. 这种方法在未成熟子宫的妇女的标准护理中没有显著的好处.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 在之前剖腹产和未成熟的子宫的妇女中,引发分娩会带来意外剖腹产和子宫破裂的高风险.
- 由于担心子宫破裂,使用福利气球的机械宫成熟通常优先于前列腺素.
- 福利气球导管可以脱离并保留在阴道中,拉动可能有助于及时移除以加快分娩进展.
研究的目的:
- 为了评估定期拉动福利气球导管对先前一次剖腹产的妇女的诱导到分娩间隔和患者满意度的影响.
- 为了比较常规的拉方案 (30秒每3小时12小时) 与标准护理 (没有拉).
主要方法:
- 马来西亚一所大学医院的一项随机对照试验,涉及126名参与者.
- 在之前一次剖腹产后接受福利气球诱导分娩的参与者被随机分配到拉组或标准护理组.
- 主要结局包括诱导到分娩间隔和患者满意度;次要结局集中在分娩进展里程碑上.
主要成果:
- 在拉组 (29.7±9.6小时) 和标准护理组 (29.8±9.1小时) (P=.950) 之间的诱导到分娩间隔没有显著差异.
- 在两组中,母亲的满意度得分相似 (中位数[IQR] 8 [7-9]与8 [7-9],P=.936).
- 剖腹产分娩率 (59%对65%,P=.238) 和剖腹产的指示,如没有进展,也相似.
结论:
- 在12个小时的安置期内,每3小时一次的Foley气球导管的例行拉动不会加速分娩,也不会增加患者的满意度,在之前的剖腹产后接受分娩诱导的妇女中.
- 这些发现表明,这种特定的拉动干预措施在这种患者群体中没有比标准护理提供临床优势.
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