| ObjectiveTo compare the clinical application effect of disposable balloon cervical dilator and oxytocin static drop on the induction of labor in the full-term pregnancy primiparas with singleton head position and immature cervix,and to investigate the application value in the induction of labor of disposable balloon cervical dilator at full-term pregnancy primiparas with unfavorable cervix.Methods1.330 primiparas with single fetal head full-term pregnancy in immature cervical(Bishop score?6 points)who were hospitalized in the Jiangsu Subei Hospital Maternity Department from June 2018 to July 2019 were randomly selected as the research objects.They were divided into the observation group(the balloon group,180 cases in the disposable balloon cervical dilator group)and the control group(the oxytocin group,150 cases in the direct application of oxytocin),according to different methods of cervical ripening.The basic information and maternal and child pregnancy outcomes of the two groups were collected,and using SPSS 25.0 software for statistical analysis.2.Search the China Biology Medicine disc,Wanfang Database,CNKI,VIP,Baidu Scholar,PUBMED,Elsevier Clinical Key,Web of Science and other Chinese and English databases.The search time is from database establishment to December 2019.Screen the retrieved literature according to the inclusion and exclusion criteria and include eligible literature on clinical controlled trial.Adopting Cochrane handbook about RCT bias risk criteria for quality evaluation,extracting basic information of the literature and research-related observation indicators,and using Rev Man5.3 software for meta-analysis,to understand the effect of mechanical labor induction in the application of full-term pregnancy primiparas.Results1.The result of 330 primiparas in our hospital:(1)There was no significant difference in the age,gestational week,height,and weight of pregnant women in the balloon group and the oxytocin group(P>0.05).(2)The balloon group had better cervical maturation effect than the oxytocin group,and the difference was statistically significant(?~2=23.746,P<0.05).(3)Compared with the oxytocin group,the balloon group could significantly reduce the rate of cesarean section,with a statistical difference(?~2=4.349,P<0.05);(4)The time from labor induction to labor,the first stage labor duration and the total stage labor duration in the balloon group were significantly less than those in the oxytocin group,with statistically significant differences(z=-5.637,P<0.05;z=-2.619,P<0.05;z=-2.513,P<0.05).(5)There was no statistically significant difference in the second stage labor duration and the volume of bleeding during 2 hours after labor between two groups(z=-0.323,P>0.05;z=-0.627,P>0.05).(6)The incidence of postpartum urinary retention in the oxytocin group was significantly higher than that in the balloon group,with statistically significant differences(?~2=5.617,P<0.05).(7)There was no statistically significant difference in the incidence of perineal postero-lateral episiotomy,puerperal infection,postpartum hemorrhage,degree II perineal laceration and cervical laceration between the two groups(P>0.05).(8)There was no significant difference between two groups in four aspects:newborn birth weight,neonatal asphyxia rate,neonatal infection rate and scalp hematoma rate(P>0.05).2.The result of the meta-analysis:(1)The meta-analysis finally included 28articles.(2)The time from labor induction to labor in the Foley catheter group,the COOK balloon group and the disposable cervical dilator balloon group was less than that in the control group,and the cervical maturation efficiency was higher than that in the control group,showing a statistical difference(P<0.00001).(3)The total stage labor duration of the three kinds of balloons was lower than that of the control group,with a statistical difference(P<0.00001).(4)The rate of cesarean section of all the three types of balloon was lower than that of the control group,and the difference was statistically significant(P<0.00001).(5)The volume of bleeding during 2 hours after labor in the disposable cervical dilator balloon group was lower than that in the control group,with statistically significant differences(MD=-70.74,95%CI=(-113.51,-27.98));The rate of postpartum hemorrhage in the disposable cervical dilator balloon group was lower than that in the control group,with statistically significant differences(OR=0.36,95%CI=(0.15,0.86)).(6)The neonatal asphyxia rate in the disposable cervical dilator balloon group was lower than that in the control group,and the difference was statistically significant(OR=0.23,95%CI=(0.09,0.57).Conclusions1.The disposable balloon cervical dilator used to induce labor in immature cervical full-term pregnancy has a good clinical effect,does not significantly increase the incidence of adverse outcomes of mothers and children,and has a high safety.In clinical application,disposable balloon cervical dilator may be preferred.2.The disposable balloon cervical dilator can promote cervical maturation,reduce the time from labor induction to labor,shorten labor process,reduce cesarean section rate,neonatal asphyxia rate,the amount of postpartum bleeding,and improve labor induction efficiency.3.The Foley catheter and the COOK cervical dilator balloon can promote cervical maturation,reduce the time from labor induction to labor,shorten labor process and reduce cesarean section rate. |
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