Clinical Observation Of Ballon With Difierent Volume For Cervical Ripening And Induction Of Labor

Background and ObjectivesThough many methods are currently available for cervical ripening during late pregnancy, there is few choices for grassroots hospitals. While low dose oxytocin is thought to be much safer to induce labor, uterine contractions and fetal heart rates must be carefully monitored during its intravenous infusion. As there are too many patients and only a few midwives in the grassroots hospitals, monitoring uterine contractions and fetal heart rates is difficult to be administered. While dinoprostone (a vaginally used Prostaglandin E2) is good for cervical ripening, it needs to be stored in freezers and is expensive for most patients in grassroot hospitals. In contrast, induction of labor with a Foley balloon catheter is simple to perform, inexpensive and with good clinical compliance, which makes it very useful in grassroot hospitals. To compare the therapeutic effects of balloon with different volume for cervical ripening and induction of labor including30ml,80ml and150ml, and investigate the advantage and disadvantage of balloon with different volume for clinical application in order to provide evidence and experience to higher effects of cervical ripening and induction of labor.Methods180pregnant women with cervical ripening, induction of labor and immature cervical condition were chose in the period from October2009to December2011in our hospital and randomly divided into three groups including30ml group (60pregnant women),80ml group (60pregnant women) and150ml group (60pregnant women); and the clinical cervical ripening efficiency, cervical score before and after induction of labor, mode of delivery, induced labor to labor,labor time, postpartum hemorrhage, the rate of neonatal asphyxia, neonatal weight and umbilical cord prolapse rate among three groups were compared.Results1.The clinical cervical ripening efficiency of30ml group,80ml group and150ml group were separately83.3%,95.0%,98.3%. The clinical cervical ripening efficiency of80ml group and150ml group were significant higher than30ml group (p<0.05); there was no significant difference in clinical cervical ripening efficiency between80ml group and150ml group (p>0.05)2. The cervical score before induction of labor of30ml group,80ml group and150ml group were separately (3.6±1.0) points,(3.7±0.9) points,(3.5±1.2) points. The cervical score after induction of labor of30ml group,80ml group and150ml group were separately (6.9±2.1) points,(10.6±3.7) points,(11.3±4.2) points. There was no significant difference in cervical score before induction of labor among three groups (p>0.05); the cervical score after induction of labor of80ml group and150ml group were significant higher than30ml group (p<0.05); there was no significant difference in cervical score after induction of labor between80ml group and150ml group (p>0.05)3. The cesarean section rate, time of induction to labor and the time of first stage of labor of80ml group and150ml group were significant better than30ml group (p<0.05); there was no significant difference in cesarean section rate, time of induction to labor and the time of first stage of labor between80ml group and150ml group (p>0.05)4. There was no significant difference in postpartum hemorrhage, neonatal asphyxia and birth weight between80ml group and150ml group (p>0.05)5. The umbilical cord prolapse rate of30ml group,80ml group and150ml group were separately0,0,3.3%. The umbilical cord prolapse rate of30ml group and80ml group were significant lower than150ml group (p<0.05); there was no significant difference in umbilical cord prolapse rate between30ml group and80ml group (p>0.05) ConclusionSmall capacity bladders with different volume possess exact effect used in cervical ripening and induction of labor. Compared with small bladders of30ml and150ml, the small bladders of80ml can efficiently decrease the risk of adverse effects, and be applied as clinical preferred way.