摘要
目的了解活跃期时限的处理对分娩方式以及妊娠结局的影响。方法2009年1月1日至12月31日，在北京大学第一医院分娩，进入产程的足月、单胎妊娠、头先露初产妇共1744例。回顾性分析其中417例活跃期时限出现异常（包括活跃期停滞和活跃期延长）者的病历资料，采用卡方检验分析活跃期停滞时间对阴道分娩和剖宫产分娩者妊娠结局的影响。结果417例活跃期停滞者中，剖宫产者205例，阴道分娩者212例。活跃期停滞发生率为23．9％（417／1744）。其中50例伴活跃期延长，发生率为2．9％（50／1744）。阴道分娩者中活跃期≥6h者新生儿转儿科率高于活跃期〈6h组E20．6％（26／126）与8．1Yoo（7／86），X2=6．07，P〈O．051，剖宫产者中活跃期〈6h者宫内感染发生率高于活跃期≥6h者[22．7％（30／132）与6．8％（5／73），X2=8．37，P〈0．01]。阴道分娩孕妇中，宫口开大6cm之前停滞者产后出血发生率（4．8％，9／186）、产妇并发症率（3．8％，7／186）和新生儿转儿科率（15．6％，29／186）与宫口开大≥6cm停滞者[分别为6．2％（1／16）、0．0Yoo（o／16）和12．5％（2／16）]比较，差异均无统计学意义（7。分别为0．12、0．01和0．00，P均〉0．05）。剖宫产孕妇中，宫口开大6cm之后行剖宫产者新生儿转儿科率明显高于宫口开大6cm之前停滞者，差异有统计学意义[60．0％（6／10）与（19．9％（34／171），X2=8．83，P〈0．05]。剖宫产孕妇宫口开大3cm时停滞时间≥4h和〈4h相比，孕妇年龄、分娩孕周、分娩时体重指数、产后出血量、新生儿出生体重等差异均无统计学意义（P均〉0．05）。单纯以活跃期停滞为指征的剖官产者新生儿转儿科率较低（11．2％，9／80），而以活跃期停滞合并宫内感染为指征的剖宫产者新生儿转儿科率较高（42．1％，16／38）。结论宫口扩张6cm以下
Objective To investigate the effects of duration of active phase on delivery mode and pregnancy outcome. Methods Data of 417 women with abnormal active phase identified from 1744 term-birth, singleton, cephalic presentation primiparas who had tried vaginal delivery in Peking University First Hospital from January 1, 2009 to December 31, 2009 were retrospectively studied. Effects of different durations of protracted active phase on pregnancy outcomes were compared between women with vaginal delivery or cesarean section by Chi-square test. Results The incidence of protracted active phase was 23.90//00 （417/1744） ; and the incidence of prolonged active phase was 2.9% （50/1744）. There were 205 cases of cesarean section and 212 cases of vaginal deliveries. The incidence of neonates hospitalization in Department of Pediatrics in vaginal delivery group with active phase ≥6 h was higher than that of those with active phase （6 h [20.6% （26/126） vs 8.1% （7/86）, X2 =6.07, P（0.05]. The incidence of intrauterine infection in cesarean section group with active phase （6 h were higher than that of those with active phase ≥6 h [22.7% （30/132） vs 6.8% （5/73）, Z2 =8.37, P〈0. 01]. In vaginal group with protracted active phase before 6 cm of cervical dilation, the incidences of postpartum hemorrhage （4.8 %, 9/186）, maternal complications （ 3.8 %, 7/186） and neonates hospitalization （15.6%, 29/186） were similar with those after 6 cm of cervical dilation [6.2% （1/16）,X2=0.12; 0.0% （0/16）, X2=0.01 and 12.5% （2/16）, X2=0.00; all P〉0.05] respectively. In cesarean delivery group with cervical dilation ≥6 cm, the incidence ofneonates hospitalization was higher than that of those with cervical dilation （6 cm [-60.0% （6/10） vs 19.9% （34/171）, x2=8.83, P（0.05]. There were no difference in maternal age, gestational age, body mass index at delivery, volume of postpartum hemorrhage and neonatal birth weight between women with cesarean section whose protracted active phase
出处
《中华围产医学杂志》
CAS
北大核心
2013年第3期148-152,共5页
Chinese Journal of Perinatal Medicine
关键词
分娩过程
剖宫产术
接生
产科
妊娠结局
Labor, obstetric
Cesarean section
Delivery, obstetric
Pregnancy outcome
