中国计划生育和妇产科
中國計劃生育和婦產科
중국계화생육화부산과
CHINESE JOURNAL OF FAMILY PLANNING & GYNECOTOKOLOGY
2015年
4期
53-56
,共4页
第二产程%电子胎心监护%胎心延长减速%新生儿结局
第二產程%電子胎心鑑護%胎心延長減速%新生兒結跼
제이산정%전자태심감호%태심연장감속%신생인결국
second stage of labor%electronic fetal heart rate monitoring%prolonged deceleration%neonatal outcomes
目的：探讨第二产程胎心延长减速（ prolonged deceleration ， PD）对新生儿结局的影响。方法回顾性分析2014年1～10月成都市锦江区妇幼保健院3977例足月单胎头位分娩产妇的临床资料，第二产程中胎心监护出现PD的874例作为观察组；胎心监护无PD的3103例作为对照组，比较两组新生儿结局。结果观察组胎盘早剥、胎儿生长受限、脐带缠绕和羊水过少的发生率（分别为2.06％、2.75％、27.0％、5.26％）高于对照组（分别为0.48％、1.06％、13.99％、1.22％）（ P＜0.05）；观察组应用缩宫素比例、第二产程时限、阴道手术产率、剖宫产率、Ⅱ度或Ⅲ度羊水粪染率[（分别为53.55％、（46.6±25.5） min、16.93％、21.97％、10.53％]高于对照组[分别为23.40％、（64.5±38.7） min、11.99％、13.02％、2.42％]（ P＜0.05）；两组新生儿窒息和新生儿转入新生儿重症监护室（ neonatal intensive care unit ， NICU）发生率比较差异无统计学意义（ P＞0.05）。观察组产妇出现PD至分娩时间超过1 h，新生儿轻、重度窒息发生率未见明显上升（P＞0.05），而新生儿转入NICU率明显上升（P＜0.05）。结论第二产程中胎心监护出现PD的发生率较高。在发生PD 1 h内结束分娩，可明显改善新生儿结局。
目的：探討第二產程胎心延長減速（ prolonged deceleration ， PD）對新生兒結跼的影響。方法迴顧性分析2014年1～10月成都市錦江區婦幼保健院3977例足月單胎頭位分娩產婦的臨床資料，第二產程中胎心鑑護齣現PD的874例作為觀察組；胎心鑑護無PD的3103例作為對照組，比較兩組新生兒結跼。結果觀察組胎盤早剝、胎兒生長受限、臍帶纏繞和羊水過少的髮生率（分彆為2.06％、2.75％、27.0％、5.26％）高于對照組（分彆為0.48％、1.06％、13.99％、1.22％）（ P＜0.05）；觀察組應用縮宮素比例、第二產程時限、陰道手術產率、剖宮產率、Ⅱ度或Ⅲ度羊水糞染率[（分彆為53.55％、（46.6±25.5） min、16.93％、21.97％、10.53％]高于對照組[分彆為23.40％、（64.5±38.7） min、11.99％、13.02％、2.42％]（ P＜0.05）；兩組新生兒窒息和新生兒轉入新生兒重癥鑑護室（ neonatal intensive care unit ， NICU）髮生率比較差異無統計學意義（ P＞0.05）。觀察組產婦齣現PD至分娩時間超過1 h，新生兒輕、重度窒息髮生率未見明顯上升（P＞0.05），而新生兒轉入NICU率明顯上升（P＜0.05）。結論第二產程中胎心鑑護齣現PD的髮生率較高。在髮生PD 1 h內結束分娩，可明顯改善新生兒結跼。
목적：탐토제이산정태심연장감속（ prolonged deceleration ， PD）대신생인결국적영향。방법회고성분석2014년1～10월성도시금강구부유보건원3977례족월단태두위분면산부적림상자료，제이산정중태심감호출현PD적874례작위관찰조；태심감호무PD적3103례작위대조조，비교량조신생인결국。결과관찰조태반조박、태인생장수한、제대전요화양수과소적발생솔（분별위2.06％、2.75％、27.0％、5.26％）고우대조조（분별위0.48％、1.06％、13.99％、1.22％）（ P＜0.05）；관찰조응용축궁소비례、제이산정시한、음도수술산솔、부궁산솔、Ⅱ도혹Ⅲ도양수분염솔[（분별위53.55％、（46.6±25.5） min、16.93％、21.97％、10.53％]고우대조조[분별위23.40％、（64.5±38.7） min、11.99％、13.02％、2.42％]（ P＜0.05）；량조신생인질식화신생인전입신생인중증감호실（ neonatal intensive care unit ， NICU）발생솔비교차이무통계학의의（ P＞0.05）。관찰조산부출현PD지분면시간초과1 h，신생인경、중도질식발생솔미견명현상승（P＞0.05），이신생인전입NICU솔명현상승（P＜0.05）。결론제이산정중태심감호출현PD적발생솔교고。재발생PD 1 h내결속분면，가명현개선신생인결국。
Objective To explore the impact of prolonged deceleration ( PD ) during the second stage of labor on neonatal outcomes.Methods Clinical data of 3 977 women of singleton, term gestation in Jinjiang Maternal and Child Health Hospital from Jan.2014 to Oct.2014 were retrospectively analyzed .874 cases with PD during the second stage of labor were selected as observation group, 3 103 cases without PD during the second stage of labor were selected as controll group ,the neonatal outcomes were compared between two groups .Results The incidences of placental abruption , fetal growth restriction , umbilical cord entanglement and oligohydramnios in observation group [2.06%、2.75%、27.0%、5.26%respectively] were significantly higher than that in the control group[0.48%、1.06%、13.99%、1.22%respectively)](P<0.05).The incidences of the application of oxytocin , the second labor time, operative vaginal delivery , cesarean section and II or III degrees amniotic fluid in observation group [53.55%、(46.6 ±25.5) min、16.93%、21.97%、10.53 respectively] were significantly higher than that in the control group [23.40%、(64.5 ±38.7) min、11.99%、13.02%、2.42% respectively] (P<0.05).The differences in incidence of neonatal asphyxia and neonatal intensive care unit (NICU) admission were not significant between two groups (P>0.05).As the extension of time from prolonged deceleration to deliver more than 1 h, the incidences of neonatal mild and severe asphyxia did not increased (P>0.05).However, the incidence of the NICU admission increased significantly (P<0.05).Conclusion The incidence of PD during the second stage of labor is high .It could improve the neonatal outcomes if delivery is completed within 1 h after PD.
