摘要
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3 977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3 103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。
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.
出处
《中国计划生育和妇产科》
2015年第4期53-56,共4页
Chinese Journal of Family Planning & Gynecotokology
关键词
第二产程
电子胎心监护
胎心延长减速
新生儿结局
second stage of labor
electronic fetal heart rate monitoring
prolonged deceleration
neonatal outcomes
