膜清扫术在降低晚期妊娠择期引产发生率中的有效性

M. Nyamzi, D. Isah, R. Offiong, A. Isah
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引用次数: 2

摘要

妊娠延长是一种高危妊娠,与孕产妇发病率增加和围产期发病率和死亡率增加有关。目的:目的是评估胎膜清扫术在减少晚期妊娠择期引产发生率方面的有效性,并比较40周时进行胎膜清扫术与未进行胎膜清扫术的妊娠结局。对象和方法:这是一项随机对照研究,于2017年9月至2018年6月进行。194名同意无阴道分娩禁忌的参与者被随机分为两组,一组在妊娠40-41周进行膜清扫,另一组仅在招募时进行阴道检查以评估Bishop评分。参与者被跟踪到分娩。结果:扫膜术可有效降低择期引产的发生率。治疗组自然分娩85例(87.6%),对照组67例(62.9%)。P < 0.001,差异有统计学意义。扫膜组引产发生率明显低于对照组(12.4% vs 37.1%;P < 0.001)。对照组从招募到入院的平均时间间隔(招募入院间隔)(5.76±2.75天)明显高于扫膜组(3.35±2.55天;P < 0.001)。结论:在低危人群中,扫膜术在减少择期引产发生率和足月妊娠持续时间方面是一种有效和安全的方法。
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Effectiveness of sweeping of membranes in reducing the incidence of elective induction of labor for postdate pregnancies
Introduction: Prolonged pregnancy is a high-risk pregnancy that is associated with increased maternal morbidity and increased perinatal morbidity and mortality. Objectives: The objective was to evaluate the effectiveness of sweeping of the fetal membranes to reduce the incidence of elective induction of labor for postdate pregnancy and to compare pregnancy outcome among women who had sweeping of membranes at 40 weeks with those who did not have sweeping of membranes. Subjects and Methods: This was a randomized, controlled study conducted from September 2017 to June 2018. One hundred and ninety-four consenting participants with no contraindication to vaginal delivery were randomized into two groups, those who had membrane sweeping at 40–41 weeks' gestation and a control group who had vaginal examination to assess Bishop score only at recruitment. Participants were followed up to delivery. Results: Sweeping of membranes effectively reduced the incidence of elective induction of labor. The proportion of those that had spontaneous labor in the treatment group was 85 (87.6%) compared to the control group that had 67 (62.9%). This was statistically significant with P < 0.001. The incidence of induction of labor was significantly lower in the membrane sweeping group compared with the control group (12.4% vs. 37.1%; P < 0.001). There was a significant higher mean time interval from recruitment to admission (recruitment admission interval) among the control group (5.76 ± 2.75 days) compared with those that had membrane sweeping (3.35 ± 2.55; P < 0.001). Conclusion: Sweeping of the membranes appears an effective and safe procedure in reducing the incidence of elective induction of labor and duration of pregnancy at term in low-risk population.
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