Clinical Evaluation For Cervical Ripening In Term Pregnancy

Objective To explore the labor of series methods usually now used for cervical ripening and induction in term pregnancy,so we can select an efficent,safe and convince method for the programed delivery of term pregnancy.Methods A total of 211 hospitalized primiparas at term(gestational weeks between 37—42)with clinical indication for induction had unfavorable cervix(Bishop scores<6)。The age of primiparas is 28.31±2.46 years and they consistent with single birth,cephalic presentation,without cephalopelvic disproportion and gestational complications。Before practicing,primiparas have understood and receive the treatment They were randomly assigned to four groups as follows,80 cases in water-balloon group(A):After removing vaginitis and rout disinfection,lay up the one-shot water-balloon to superior endostoma of cervix with clamp along the cervical canal lateral wall,then reject 150ml isotonic Na chloride to water-balloon and drag ectad gently to make the water-balloon pressing to endostoma of cervix.Vessel in vagina was encapsulated by aseptic bandage.The water-balloon will prolapse in labor; if there is not natural parturient signs,take out of the water-balloon within 24 hours, then to undertake Bishop scores.According to intensity of uterine contraction,adjust the velocity of intravenous drip of oxytocin(2.5U oxytocin input to 500ml 5% glucose)to maintain effectual uterine contraction.45 cases in oxytocin group(B): 0.5-1%oxytocinⅣdroping once daily for 1-3 days consecutively.46 cases in misoprotol group(C):laying up 25μg misoprotol in posterior fornix of vagina and stopping medication if showing up regular uterine contraction.It needs to repeat when there is no uterine contraction or irregular uterine contraction after 3-4 hours,but the number of times of medication should not beyond 6.50 cases in propess group(D): propess(10mg)attaching recoverable assemblage and releasing persistently and uniformly was putted into posterior fornix of vagina.It should be taken out immediately on the circumstance of in labor,membrane rupturing,excessive stimulation of uterus,fetal distress,severe nausea and vomiting,hypotension and so on,otherwise it should be taken out after 12 hours.Every primipara needs to be observed by specialized doctor before and after treatment and checked through anus and undertaken Bishop scores.Once the primipara is in labor,observing birth process, way of delivery,condition of infant,quantity of postpartum hemorrhage,side reaction rigorously.Evaluation criterion of effect:excellent,scores increase≥3;valid, scores increase 1-2;inactive,scores unchanged.The total effective power contends excellence and utility.Results Bishop score was increased by 9.28±2.20 points in water ballon group,which is highest among four groups(p<0.05),and the cesarean section rate of it was lawest among the groups(p<0.05).The time of labor starting and totorl in propess group were the shortest(p<0.05).Conclusions water ballon is an ideal way of promoting cervical ripening,which is safe and effective.