足月顺产新生儿脐带自然搏动时间及与母婴结局的关系  

Duration of umbilical cord pulsing and maternal and neonatal outcomes in full term neonatal after normal labor

作　　者：华少萍[2] 张宏玉[1] 郑思华[2] 凌奕[2] 

机构地区：[1]海南医学院国际护理学院,海口571101 [2]海南医学院附属医院妇产科,海口571101

出　　处：《中国生育健康杂志》2012年第2期93-95,共3页Chinese Journal of Reproductive Health

基　　金：海南卫生厅课题（2007-55）资助学报项目（编号：（00201000）

摘　　要：目的分析足月顺产新生儿出生后脐带自然搏动的时间以及与母儿结局的关系。方法观察和记录120例新生儿出生后脐带自然搏动停止的时间；按脐带自然搏动时间分为〈60S、60-90S、〉908，比较各组的母婴结局。结果脐带自然搏动时间为18-540s，平均（120．1±85．9）s，中位数90．0s。脐带搏动时间〈60S组的胎盘端的残血量、新生儿胆红素、第三产程时间、产后出血量、新生儿高危监护比例分别为（42．7±24．9）ml、（15．6±1．7）g/L、（11．5±4．1）min、（197．6±86．6）ml、20％（5／25），均高于其它两组，差异有统计学意义。结论脐带自然搏动时间长，显示了更好的母婴结局，或更健康的新生儿；研究支持应等待脐带自然搏动停止后断脐。Objective To examine the association between duration of umbilical cord pulsing and maternal and neonatal outcomes in full term babies after normal labor. Methods Data were drawn from clinical records of full term normal delivery babies. Umbilical cord was clamped and cut until the cease of umbilical cord pulsing. Selected maternal and neonate health parameters were analyzed by duration of cord pulsing. Results The shortest pulsing time was 18 sec- onds, and the longest 540 seconds, with an average of （120.1 ~ 85.9） seconds and a median of 90.0 seconds. In those with pulsing time shorter than 1 min, there was a larger amount of postpartum bleeding （197.6 -＋ 86.6） ml, less residual blood in placenta （ 42.7 ~ 24.9） ml, higher level of peak bilirubin of newborns after birth （ 15.6 ~ 1.7 ） g/L, longer third stage （ 11.5 ~ 4.1 ） min, and higher rate of neonatal transfer to neonatal intensive care unit （20 % ）, when compared with those with pulsing time longer than 1 min. Conclusion Longer postpartum umbilical cord pulsing may be associated with better maternal and neonatal outcomes. Or it can be explained that the healthier babies have longer cord pulsing time. The results support the practice of clamping and cutting the cord after the umbilical cord stops pulsing.

关 键 词：新生儿 脐带搏动 母婴结局 新生儿贫血 

分 类 号：R722[医药卫生—儿科]