第二产程时间与新生儿窒息的探讨  

Relation between the duration of second stage of labor and neonatal asphyxia

作　　者：蔡卫华[1] 

机构地区：[1]广东省佛山市妇儿医院,528000

出　　处：《中国妇幼保健》2004年第4X期107-108,共2页Maternal and Child Health Care of China

摘　　要：目的:探讨第二产程与新生儿窒息的关系,选择最佳分娩时间。方法:回顾性分析2 433例足月单胎头位阴道分娩的新生儿轻、重度窒息,羊水Ⅰ~Ⅲ度污染,胎心电子监护(EFM)异常的资料,其中产妇第二产程【1 h分娩2 100例,≥1~2 h分娩301例。≥2 h分娩32例。结果:【1 h分娩新生儿轻、重度窒息134例,占6.38％,羊水Ⅲ度污染98例,占4.66％,EFM异常238例,占11.33％;≥1 h~【2 h分娩新生儿轻、重度窒息90例,占29.90％,羊水Ⅲ度污染27例,占8.97％,EFM异常135例,占44.85％;≥2 h分娩新生儿轻、重度窒息17例,占53.13％,羊水Ⅲ度污染13例,占40.6％,EFM异常23例,占71.87％,差异有高度显著性(P【0.01)。结论:第二产程中【1 h分娩新生儿窒息明显减少,】1 h分娩新生儿窒息随着时间延长而增加。建议将第二产程控制在1 h内,以减少新生儿窒息发生率。Objective: To find out the relation between second stage of labor and neonatal asphyxia, in order to choice the proper duration of second stage of labor. Methods: 2 433 cases in out hospital which were full term labor and cephalic presentation and normal labor retrospectively were studied. The duration of second stage of labor of 2 100 cases were less 1 hour, ones of 301 cases were 1 hour-2 hours, and ones of 32 cases were more than 2 hours. The materials of severe or slight neonatal asphyxia and Ⅰ°-Ⅱ° amniotic fluid meconium staining and abnormal electron fetal heart monitoring (EFM) were studied. Results: Duration < 1 houir: severe or slight neonatal asphyxia 134 cases (6. 38%), Ⅱ° amniotic fluid meconium staining 98 cases (4. 66%), abnormal EFM 238 case (11. 33%). Duration ≥1 hour and <2 hours: severe or slight meonatal asphyxia 90 cases (29. 90%), amniotic fluid mecornium staining 27 cases (8.97%), abnormal EFM 135 cases (44.85%) . Duration ≥2 hours: severe or slight neonatal asphyxia 17 cases (53.13%), Ⅱ° amniotic fluid meconium staining 13 cases (40.6%), abnormal EFM 23 cases (71.87%) . Difference was significant (P<0. 01) . Conclusion: If the duration of second stage of labor is less than 1 hour, the incidence rate of neonatal asphyxia will decrease. If the duration of second stage of labor is more than 1 hour, the incidence rate of neonatal asphyxia will increase with the prolongation of duration of second stage of labor. All in a word, to control the duration of second stage of labor within 1 hour will decrease the incidence rate of neonatal asphyxia.

关 键 词：第二产程 新生儿窒息 分娩 羊水 胎心率 

分 类 号：R714.7[医药卫生—妇产科学]