摘要
目的探讨第二产程时长与新生儿窒息和产后出血的关系。方法选取2016年6月至2018年6月于中国人民解放军战略支援部队特色医学中心住院分娩的230例初产妇为研究对象,根据产妇第二产程时长,将其分为A组(第二产程<2 h)、B组(2 h≤第二产程≤3 h)、C组(第二产程>3 h),统计三组产妇分娩方式、产后出血和新生儿窒息发生情况。结果三组产妇经阴道分娩率、中转剖宫产率和会阴侧切率比较差异均有统计学意义(均P<0.05),C组产妇经阴道分娩率显著低于A组和B组(均P<0.05),中转剖宫产率和会阴侧切率均显著高于A组和B组(均P<0.05)。三组产妇产后出血、产后尿潴留、产后发热、会阴切口感染发生率比较差异均无统计学意义(均P>0.05),软产道裂伤发生率比较差异有统计学意义(P<0.05),但软产道裂伤程度比较差异无统计学意义(P>0.05)。A组产妇软产道裂伤发生率显著高于B组和C组(均P<0.05)。三组新生儿窒息发生率比较差异有统计学意义(P<0.05),其中C组新生儿窒息发生率显著高于A组(P<0.05)。结论将未采用分娩镇痛的初产妇的第二产程时长控制于≤3 h,可降低新生儿窒息和产后出血发生率,保障母婴安全。
Objective To investigate the relationship between the duration of second stage of labor and neonatal asphyxia and postpartum hemorrhage.Method A total of 230 primiparas who were hospitalized and delivered in Strategic Support Force Specialty Medical Center of Chinese People's Liberation Army from June 2016 to June 2018 were included in the study.According to the duration of second stage of labor,they were divided into group A(second stage of labor<2 h),group B(2 h≤second stage of labor≤3 h)and group C(second stage of labor>3 h).The delivery modes,maternal postpartum hemorrhage and neonatal asphyxia were counted in the three groups.Result There were significant differences in vaginal delivery rate,the rate of transfer to cesarean section and the rate of lateral episiotomy among the three groups(all P<0.05),and the vaginal delivery rate in group C was significantly lower than that in groups A and B(all P<0.05),while the rates of transfer to cesarean section and lateral episiotomy were significantly higher than those in groups A and B(all P<0.05).There were no significant differences in the incidence rates of postpartum hemorrhage,postpartum urinary retention,postpartum fever and perineal incision infection among the three groups(all P>0.05).There was a significant difference in the incidence rate of soft birth canal laceration among the three groups(P<0.05),but there was no significant difference in the degree of soft birth canal laceration among the three groups(P>0.05).The incidence rate of soft birth canal laceration in group A was significantly higher than that in groups B and C(all P<0.05).There was a significant difference in the incidence rate of neonatal asphyxia among the three groups(P<0.05),and the incidence rate of neonatal asphyxia in group C was significantly higher than that in group A(P<0.05).Conclusion The duration of second stage of labor controlled within 3 h for primiparas without labor analgesia can control the incidence rates of neonatal asphyxia and postpartum hemorrhage and ensure the maternal-infant safety.
作者
董运征
张兰梅
周玲
王敏
王鑫
陈秀芳
张妍
Dong Yunzheng;Zhang Lanmei;Zhou Ling;Wang Min;Wang Xin;Chen Xiufang;Zhang Yan(Department of Obstetrics and Gynecology,Strategic Support Force Specialty Medical Center of Chinese People's Liberation Army,Beijing 100001,China)
出处
《中国医学前沿杂志（电子版）》
2020年第3期108-111,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
第二产程
新生儿窒息
产后出血
Second stage of labor
Neonatal asphyxia
Postpartum hemorrhage
