Practical Analysis Of Disposable Balloon Cervical Dilator By Cervical Ripening Of Induction In Gestational Diabetes Women

Objective:To compare the utility of disposable balloon cervical dilator and dinoprostone suppository in the cervical ripening during gestational diabetes induction.And expand the scope of application of disposable balloon cervical dilator to increase the possibility of vaginal delivery,minimize cesarean section rates,and reduce maternal and child damage.Methods:From January 2015 to December 2016,106 primary primipara pregnant women who were diagnosed gestational diabetes mellitus(GDM)after 24 weeks were hospitalized in our hospital.Randomly divided the women into disposable balloon cervical dilator group(61 cases)and dinoprostone suppository group(45 cases).There was no significant difference in age,gestational age,and cervical score between the two groups(P>0.05).The t and?~2 test were used to compare the success rate of induction,outcomes of delivery and adverse reactions of the two groups,and to compare the effectiveness and safety of the two methods by cervical ripening.In addition,3 cases of gestational diabetes with hypertensive disorder during pregnancy,6 cases of gestational diabetes with suspected fetal distress,and 4 cases of gestational diabetes with uterine fibroids as special cases were included into the study.Result:1.There was no statistical difference in the age,gestational age,and cervical score between the two groups(P>0.05).2.Effectiveness of two groups by promote cervical ripening and induction of labor:Both methods can significantly increase the cervical Bishop score,promote cervical ripening and vaginal delivery.The success rate of induction more than 70%,but there were no significant differences between the two groups(P>0.05).The time from induction to the beginning of labor in the dinoprostone suppository group was significantly shorter than disposable balloon cervical dilator group.The artificial membrane rupture rate and oxytocin use rate in disposable balloon cervical dilator group were significantly higher than dinoprostone suppository group.The differences were statistically significant(P<0.05).The indications for changing to cesarean section in both groups have no significant difference(P>0.05).3.The safety for promote cervical ripening in two groups:There were no serious adverse reactions in two groups,include uterine rupture,placental abruption and cervical vaginal laceration.The incidence of uterine tonic contraction and the rate of withdrawal in the dinoprostone suppository group were significantly higher than disposable balloon cervical dilator group(P<0.05).The amount of blood loss in24 hours after vaginal delivery did not exceed 500ml in both groups.There was no puerperal infection and neonatal asphyxia in both groups.4.Disposable balloon cervical dilator can also be used in pregnant women with gestational diabetes complicated with hypertensive disorder during pregnancy,gestational diabetes with suspected fetal distress,and gestational diabetes with uterine fibroids,and has good effect.Conclusion:Cervical ripening in late trimester of pregnancy is an effective method to reduce cesarean section rate and increase vaginal delivery.Disposable balloon cervical dilator and dinoprostone suppository are safe and effective cervical ripening methods for pregnant women with gestational diabetes.Compared to dinoprostone suppository,the disposable balloon cervical dilator has milder effect,and has no drug side effects and discomfort,operate easily.It has wider clinical indications,and more suitable for cervical ripening in pregnant women with gestational diabetes.Has a good clinical application value.