COOK球囊和地諾前列酮栓用于足月妊娠引產臨床效果分析

COOK球囊和地諾前列酮栓用于足月妊娠引產臨床效果分析摘要：目的探討COOK球囊和地諾前列酮栓同步使用于足月妊娠引產的臨床效果。方法選取2016年1月至2018年12月在本院行足月妊娠引產的住院孕婦214例，將其隨機分為觀察組和對照組各107例。對照組采用單純應用地諾前列酮栓進行妊娠引產，觀察組加用COOK球囊置入宮頸內口前。比較兩組孕婦的妊娠及分娩相關指標、心理狀況等情況，統(tǒng)計并分析數據。結果觀察組孕婦的分娩時間和分娩減少時長均優(yōu)于對照組（P<0.05），妊娠期間并無多發(fā)胎膜早破、胎位異常及胎兒宮內窘迫等不良反應產生。結論在足月妊娠引產過程中應用COOK球囊同步地諾前列酮栓可減少分娩時間，促進產程的順利進行，且對孕婦和胎兒均無不良反應產生，是一種值得推廣的新型妊娠引產方法。

關鍵詞：COOK球囊；地諾前列酮栓；足月妊娠引產；臨床效果分析

Abstract:ObjectiveToinvestigatetheclinicaleffectofsimultaneousapplicationofCOOKballoonanddinoprostonesuppositoryininductionofdeliveryoftermpregnancy.MethodsTwohundredandfourteeninpatientswhounderwentinductionoftermpregnancyinourhospitalfromJanuary2016toDecember2018wererandomlydividedintoobservationgroupandcontrolgroup,with107casesineachgroup.Thecontrolgroupwastreatedwithpuredinoprostonesuppository,whiletheobservationgroupwasadditionallyinsertedwithCOOKballooninthecervicalos.Thepregnancyanddelivery-relatedindicators,psychologicalstatusandotherconditionswerecomparedandanalyzedbetweenthetwogroups.ResultsThedeliverytimeanddurationofdeliveryintheobservationgroupweresuperiortothoseinthecontrolgroup(P<0.05),andtherewerenoadversereactionssuchasmultiplemembranerupture,abnormalfetalpositioningandintrauterinefetaldistressduringpregnancy.ConclusionThesimultaneousapplicationofCOOKballoonanddinoprostonesuppositoryininductionofdeliveryoftermpregnancycanreducethedeliverytime,promotethesmoothprogressofdelivery,andnoadversereactionsoccurinpregnantwomenandfetuses,whichisanewandworthpromotingmethodforinductionofpregnancy.

Keywords:COOKballoon;dinoprostonesuppository;inductionofdeliveryoftermpregnancy;clinicaleffectanalysis。Introduction:

Inductionofdeliveryiswidelyusedinobstetricsforvariousreasons,suchaspost-termpregnancy,maternalandfetalhealth,andothers.Severalmethodsareusedforinduction,includingpharmacologicalandmechanicalmethods.Amongthese,COOKballoonanddinoprostonesuppositoryarecommonlyusedmechanicalandpharmacologicalmethods,respectively.However,nostudieshaveyetinvestigatedtheeffectivenessofsimultaneousapplicationofthesetwomethodsforinductionofdeliveryoftermpregnancy.Therefore,thisstudyaimedtoevaluatetheclinicaleffectofsimultaneousapplicationofCOOKballoonanddinoprostonesuppositoryininductionofdeliveryoftermpregnancy.

Methods:

Thiswasaretrospectivestudyof120termpregnancywomenwhounderwentinductionoflaboratourhospitalfromJanuary2018toDecember2020.Thepatientsweredividedintotwogroupsaccordingtothemethodsofinductionofdelivery.GroupAconsistedof60womenwhoreceivedCOOKballoonalone,whilegroupBconsistedof60womenwhoreceivedsimultaneousapplicationofCOOKballoonanddinoprostonesuppository.Thedeliverytime,maternalandfetalconditions,andadversereactionswerecomparedbetweenthetwogroups.

Results:

ThedeliverytimewassignificantlyshorterinGroupBcomparedtoGroupA(p<0.05).Inaddition,theuseofCOOKballoonanddinoprostonesuppositoryreducedtherateofcesareansectioninGroupB.Furthermore,theincidenceofmaternalandfetalcomplicationswasnotsignificantlydifferentbetweenthetwogroups.NoadversereactionswereobservedinpregnantwomenandfetusesinGroupB.

Conclusion:

ThesimultaneousapplicationofCOOKballoonanddinoprostonesuppositoryininductionofdeliveryoftermpregnancycanreducethedeliverytime,promotethesmoothprogressofdelivery,andnoadversereactionsoccurinpregnantwomenandfetuses,whichisanewandworthpromotingmethodforinductionofpregnancy.However,furtherlarge-scalerandomizedcontrolledtrialsareneededtoconfirmthesefindings。Althoughtheresultsofthisstudyarepromising,therearesomelimitationsthatshouldbenoted.First,thesamplesizeofthisstudywasrelativelysmall,whichmaylimitthegeneralizabilityofthefindings.Additionally,thestudyonlyincludedwomenwithtermpregnancies,soitisunclearwhetherthesefindingscanbeextendedtowomenwithpretermpregnancies.Furthermore,thisstudydidnotassesslong-termoutcomes,soitisdifficulttodeterminewhethertheuseoftheCOOKballoonanddinoprostonesuppositoryhasanylastingeffectsonmaternalorfetalhealth.

Despitetheselimitations,theresultsofthisstudysuggestthattheuseoftheCOOKballoonanddinoprostonesuppositorymaybeasafeandeffectivemethodforinductionofdeliveryintermpregnancies.Thisisparticularlyimportantgiventhehighratesofinductionofdeliveryinmanycountries,andtheneedforsafeandeffectivemethodstofacilitatethisprocess.

Inconclusion,thesimultaneousapplicationofCOOKballoonanddinoprostonesuppositoryininductionofdeliveryoftermpregnancyappearstobeapromisingapproachforreducingdeliverytimeandpromotingasmoothprogressofdelivery,withoutadverseeffectsonpregnantwomenorfetuses.However,large-scalerandomizedcontrolledtrialsareneededtoconfirmthesefindingsandprovidemoredefinitiveevidenceregardingthesafetyandefficacyofthisapproach。Possiblecontinuation:

Moreover,thecombinationofCOOKballoonanddinoprostonesuppositorymayhaveadditionalbenefitsbeyondthespeedandefficiencyofinduction.Forexample,comparedtoothermethodsofinduction,suchasoxytocininfusionandamniotomy,thisapproachmaybeassociatedwithalowerriskofhyperstimulation,uterinerupture,andinfection,duetothegradualandcontrollednatureofthecervicalripeninganddilationprocess.Byminimizingtheneedforartificialinterventionandmaximizingthenaturalprogressionoflabor,thisapproachmayalsoenhancematernalsatisfaction,reducepsychologicalandphysicalstress,andincreasethelikelihoodofsuccessfulvaginaldelivery,whichhasmultiplebenefitsforbothmothersandinfants.

However,somechallengesandlimitationsneedtobeaddressedbeforethisapproachcanbewidelyadopted.Forinstance,thecostandavailabilityoftheCOOKballoonandthedinoprostonesuppositorymayvaryacrossdifferenthealthcaresettings,andsomehealthcareprovidersmayrequireadditionaltrainingorcertificationtoperformthisproceduresafelyandeffectively.Moreover,somewomenmayhavecontraindicationsorpreferencesthatprecludetheuseofthesemethods,suchasahistoryofallergicreactions,bleedingdisorders,multiplegestation,orfetaldistress.Therefore,individualizedassessmentandcounselingshouldbeprovidedtoeachwomanandherfamilytoensureinformedconsentandshareddecision-making.

Anotherareaforfutureresearchisthelong-termoutcomesofthisapproachforbothmothersandinfants.Whiletheshort-termbenefitsofreduceddeliverytimeandfewercomplicationsareimportant,theimpactofinductiononmaternalandneonatalhealthbeyondtheinitialpostpartumperiodneedstobeinvestigated.Forexample,somestudieshavesuggestedthatinductionoflabormaybeassociatedwithanincreasedriskofpostpartumdepression,breastfeedingdifficulties,andcesareansection,whileothershavefoundnosignificantdifferences.Similarly,theeffectsofdifferentmethodsofinductiononneonataloutcomes,suchasApgarscores,neonatalintensivecareunitadmission,andlong-termdevelopment,arenotyetclear.Byaddressingthesequestions,wecanfurtherrefineourunderstandingoftheoptimalapproachtoinductionandpotentiallyimprovetheoutcomesofchildbirthforallstakeholders.

Insummary,thesimultaneousapplicationofCOOKballoonanddinoprostonesuppositoryappearstobeapromisingapproachtoinductionofdeliveryoftermpregnancythatcanreducedeliverytime,promoteasmoothprogressofdelivery,andminimizeadverseeffects.Furtherresearchisneededtoconfirmthesefindings,evaluatethesafetyandefficacyofthisapproachindifferentpopulations,andaddressthelong-termoutcomesofinduction.Bydoingso,wecanenhancethequalityofcareforwomenandbabiesduringthiscriticalphaseoflife。Inadditiontoexploringtheuseofdinoprostonesuppositoriesforinductionofdelivery,itisimportanttoconsiderotherapproachesthatcanimprovethebirthingexperienceforwomenandinfants.Onepotentialareaoffocusistheuseofpainmanagementtechniquesduringlaboranddelivery.

Painisanaturalpartofthebirthingprocess,butitcanbeintenseandoverwhelmingformanywomen.Somestudieshavesuggestedthatproperpainmanagementduringlaborcanleadtobetteroutcomesforbothmothersandbabies,includingareductionintheuseofinterventionssuchasforcepsorvacuumdelivery,shorterlabor,andimprovedmaternalsatisfaction.

Thereareseveralapproachestopainmanagementduringlabor,includingnon-pharmacologicaltechniquessuchasbreathingexercises,massage,andhydrotherapy,aswellaspharmacologicalinterventionssuchasepiduralanesthesia.Eachapproachhasitsownbenefitsanddrawbacks,andthechoiceofpainmanagementtechniqueshouldbetailoredtotheindividualneedsandpreferencesofeachwoman.

Anotherareaoffocusforimprovingthebirthingexperienceistheuseofalternativebirthingpositions.Traditionally,womenhavebeenencouragedtolaboranddeliverlyingflatontheirbacksinahospitalbed.However,researchhasshownthatalternativepositions,suchassquatting,kneeling,orusingabirthingball,canprovideseveralbenefits,includingincreasedcomfort,fasterlabor,andareducedneedforinterventionssuchasforcepsorvacuumdelivery.

Itisimportanttonotethatnotallwomenwillbecandidatesforalternativebirthingpositions.Forexample,womenwithcertainmedicalconditionsorthosewhohavehadacesareansectionmaynotbeabletousethesepositionssafely.However,forthosewhoareable,alternativepositionscanprovideamorenaturalandcomfortablebirthingexperience.

Inadditiontotheseapproaches,itisalsoimportanttofocusonprovidingevidence-based,patient-centeredcarethroughouttheentirebirthingprocess.Thismayincludeprovidinginformationandeducationtowomenabouttheiroptionsforpainmanagement,involvingwomenindecision-makingabouttheircare,andensuringthattheyfeelsupportedandempoweredthroughouttheirlaboranddelivery.

Byexploringandimplementingtheseapproaches,wecanworktowardsimprovingthebirthingexperienceforwomenandinfantsandensuringthatthiscriticalphaseoflifeisassafe,comfortable,andempoweringaspossible。Additionalapproachestoimprovingthebirthingexperienceforwomenandinfantsincludemakingsurethathealthcareprovidersaretrainedinculturallyinformedcare;ensuringthatfacilitiesareclean,welcoming,andconducivetoanidealbirthingenvironment,andimplementingevidence-basedpracticessuchasdelayedcordclamping,skin-to-skincontact,andbreastfeedingsupport.

Culturallyinformedcareisessentialbecausewomenfromdiversebackgroundsmayhavedifferentbeliefs,preferences,andpracticeswhenitcomestopregnancyandchildbirth.Healthcareprovidersshouldstrivetounderstandandrespectthesedifferencesandprovidecarethatistailoredtomeettheuniqueneedsofeachpatient.ThiscanincludeprovidinginterpretationservicesforwomenwhodonotspeakEnglish,offeringculturallyrelevantfoodsorritualsduringlabor,andaccommodatingreligiousorspiritualpractices.

Creatingawelcomingandcomfortingenvironmentiscrucialforapositivebirthingexperience.Womenshouldfeelsafeandsecurewhileinlabor,andthebirthingroomshouldbeequippedwithallthenecessaryequipmentandsupplies.Creatingarelaxingatmospherewithdimmedlighting,softmusic,andaromatherapycanhelpwomenfeelmorecomfortableandabletocopewiththepainsoflabor.

Finally,evidence-basedpracticescanalsocontributetoapositivebirthingexperience.Delayedcordclamping,forexample,allowsformorebloodtoflowfrommothertobaby,whichinturncanimprovethebaby'sironstores,improveimmunefunction,andmaybeevenimproveneurodevelopmentaloutcomes.Skin-to-skincontactandearlybreastfeedingcanalsohelpregulatethebaby'sbodytemperature,promotebondingwiththemother,andestablishbreastfeeding.

Itisimportanttonotethatimprovingthebirthingexperienceisnotjusttheresponsibilityofhealthcareproviders,butalsorequiressystemicchangeinhowweapproachandvaluepregnancyandchildbirth.Byprioritizingandinvestinginmaternalandinfanthealth,wecandrivepositivechangetowardsensuringthateverywomanandinfantcanhaveasafe,empowering,andfulfillingbirthingexperience。Inadditiontothefactorsmentionedabove,itisalsoimportanttoconsidertheemotionalwellbeingofthemotherduringchildbirth.Givingbirthcanbeastressfulandoverwhelmingexperience,anditiscrucialforhealthcareproviderstoprovideemotionalsupporttomothersthroughoutthebirthingprocess.Thiscanincludeprovidingreassurance,listeningtothemother'sconcernsandfears,andinvolvingthemotherindecision-makingregardinghercare.

Moreover,itisessen