胎儿窘迫孕妇剖宫产110例分析  

Analysis of fetal distress served as andication of cesarean section in 110 cases

作　　者：郭玉清[1] 邢淑敏[1] 

机构地区：[1]中日友好医院妇产科

出　　处：《中华妇产科杂志》1995年第2期87-89,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：将我院１９９２年７月～１９９３年１０月因胎儿窘迫行剖宫产的孕妇１１０例，依胎心外监护、羊水情况分为三组：重度胎心异常１３例（Ⅰ组）；单纯轻、中度胎心异常４９例（Ⅱ＿Ａ），同时伴羊水Ⅲ度粪染１１例（Ⅱ＿Ｂ组）；单纯羊水Ⅲ度粪染３７例（Ⅲ组），并与术中所见及新生儿Ａｐｇａｒ评分对照。结果：Ⅰ组新生儿Ａｐｇａｒ评分≤７分的发生率为４６．２％，胎儿窘迫相关因素发生率为９２．３％，明显高于Ⅱ组、Ⅲ组之和。表明：Ⅰ组胎儿存在或潜在缺氧情况，应及时娩出；其余各组伴有高危因素者也应积极娩出胎儿或在严密监护下按胎儿窘迫处理，有好转者可继续妊娠并争取阴道分娩；否则，以剖宫产为宜。esarean section performed in 110 cases with an indication of fetal distress from July, 1992 to Oct,1993 was analysed,according to the abnormalities of external fetal heart monitoring and amniotic fiuid,110 cases were divlued into 3 groups: group Ⅰ severe abnormalities of fetal heart rate in 13 cases. Group Ⅱ mild or mederate abnormalities of fetal heart rate only (Ⅱ_A) in 49 cases, combined with meconium stained amniotic fluid grade Ⅲ(Ⅱs ). Group Ⅲ meconium stained amniotic fluid grade Ⅲ only in 37 cases. Cheking by findings during operation and Apgar score of newborns has been done in each group. The rate of newborns with fow Apgar Score was 46.2%and the occurrence of factors assOciated with fetal distress was 92.3%in groupⅠ.The differences between group Ⅰ and two other groups altogather were apparently singnificant.It demonstrated that hypoxia or underlying hypoxia most likely exists in groupⅠ.Therefore rapid delivery was the best choice. Under close observation and monitoring,preg-nancy and trial labor might continue in group Ⅱ_A and group Ⅱ_B or Ⅲ with an exception in patient compli-cated with high risk factors. However vaginal delivery was reasOnable if labour could finish within 1～2 hours.

关 键 词：胎儿窘迫症 剖腹 胎儿监测 洋水 

分 类 号：R714.43[医药卫生—妇产科学]