新产程模式下对枕后位难产孕妇不同分娩结局的评估  

Evaluation of different delivery outcomes of pregnant women with occipital posterior dystocia under the new stage of labor

作　　者：张伟锋 舒艳 唐克峰 李琼珊 牟兰芳 ZHANG Weifeng;SHU Yan;TANG Kefeng;LI Qiongshan;MOU Lanfang(Department of Obstetrics and Gynecology,Huzhou Women's and Children's Hospital,Huzhou 313000,Zhejiang,China)

机构地区：[1]浙江省湖州市妇女儿童医院妇产科,浙江湖州313000

出　　处：《中国现代医生》2022年第20期63-66,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019RC287);浙江省湖州市科技计划项目(2019GY37)。

摘　　要：目的探讨新产程模式下剖宫产和产钳术对持续性枕后位难产孕妇分娩结局的评估。方法选择2017至2020年于浙江省湖州市妇女儿童医院收住入院的103例持续性枕后位难产孕妇,其中以产钳分娩的60例孕妇为研究组,以剖宫产术分娩的53例孕妇为对照组,评估其分娩结局,比较剖宫产及产钳分娩两组新生儿窒息、产后出血、产时、产后感染、软产道裂伤(包括会阴Ⅲ度裂伤、阴道裂伤、宫颈裂伤)、切口预后不良的差异。结果研究组产后出血、产时发热、产后发热发生率分别为1.66%、1.66%、3.33%,明显低于对照组分别为11.32%、13.20%、15.09%,但研究组会阴Ⅲ度裂伤、宫颈裂伤、阴道裂伤发生率分别为15.00%、13.33%、11.66%,分别明显高于对照组1.88%、1.88%、3.77%,差异有统计学意义(P<0.05)。但研究组的新生儿窒息发生率及切口预后不良的比率分别为8.33%、6.66%,略低于对照组11.32%、7.54%,差异无统计学意义(P>0.05)。结论新产程标准下持续性枕后位难产孕妇选择产钳分娩可明显降低产时、产后感染及产后出血的发生率,但软产道裂伤发生率较高,所以持续性枕后位难产孕妇选择产钳分娩是相对比较安全的分娩方式,但同时需要注意软产道裂伤的发生。Objective To explore the evaluation of cesarean section and forceps on the delivery outcome of pregnant women with persistent occipitoposterior dystocia under the new mode of labor.Methods A total of 103 pregnant women with persistent occipitoposterior dystocia admitted to our hospital from 2017 to 2020 were selected,included 60 pregnant women with forceps delivery as the study group and 53 pregnant women with cesarean section as the control group.The delivery outcomes were evaluated.The neonatal asphyxia,postpartum hemorrhage,intrapartum,postpartum infection,soft birth canal laceration(including perinealⅢdegree laceration,vaginal laceration and cervical laceration)and the difference of poor prognosis of incision were compared between two groups.Results The incidence of postpartum hemorrhage,intrapartum fever and postpartum fever in the study group 1.66%,1.66%and 3.33%,respectively was significantly lower than that in the control group 11.32%,13.20%and 15.09%,but the study group had gradeⅢperineal laceration,cervical laceration,vaginal laceration.The incidence rates were 15.00%,13.33%and 11.66%respectively,which were significantly higher than those in the control group 1.88%,1.88%and 3.77%,and the difference was statistically significant(P<0.05).However,the incidence of neonatal asphyxia and the proportion of poor incision prognosis in the study group were 8.33%and 6.66%respectively,which were slightly lower than those in the control group 11.32%and 7.54%,and the difference was not statistically significant(P>0.05).Conclusion Under the new labor process standard,the selection of forceps for pregnant women with persistent occipitoposterior dystocia can significantly reduce the incidence of intrapartum,postpartum infection and postpartum hemorrhage,but the incidence of soft birth canal laceration is higher.Therefore,it is relatively safe for pregnant women with persistent occipitoposterior dystocia to choose forceps delivery,but at the same time,we need to pay attention to the occurrence of soft birth canal lac

关 键 词：新产程模式 持续性枕后位 产钳分娩 剖宫产分娩 

分 类 号：R711.72[医药卫生—妇产科学]