足月孕妇产程中绒毛膜羊膜炎不同分娩时间和方式对新生儿出生结局的影响  

Effects of different timing and mode of delivery on neonatal birth outcomes in full-term women with chorioamnionitis during labor

作　　者：刘鑫 董兆祥 卜秀华 汪霆 李静 LIU Xin;DONG Zhaoxiang;BU Xiuhua;WANG Ting;LI Jing(Obstetrics and Gynecology Branch of Dalian Municipal Women and Children's Medical Center(Group),Dalian 116021,China)

机构地区：[1]大连市妇女儿童医疗中心(集团)妇产院区,辽宁大连116021

出　　处：《中国妇产科临床杂志》2024年第4期331-334,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨足月孕妇在产程中诊断绒毛膜羊膜炎(chorioamnionitis)后,不同分娩时间(诊断至胎儿娩出的时间)和分娩方式对新生儿出生结局的影响。方法回顾性分析2021年1月至12月在本院区临产后诊断为绒毛膜羊膜炎411例足月孕妇的资料,比较不同分娩时间和分娩方式对新生儿Apgar评分、脐动脉血气p H及乳酸值、入新生儿重症监护室(NICU)、感染性疾病和代谢性酸中毒的影响。结果不同分娩时间的新生儿Apgar评分、脐动脉血气、入NICU、感染性疾病和代谢性酸中毒发生率比较,差异均无统计学意义(P>0.05)。不同分娩方式的新生儿Apgar评分、入NICU、感染性疾病和代谢性酸中毒发生率比较,差异均无统计学意义(P>0.05);剖宫产组脐动脉血气p H(中位数7.30)优于阴道分娩组(中位数7.28),剖宫产组乳酸水平(中位数2.30 mmol/L)优于阴道分娩组(中位数4.10 mmol/L),差异均有统计学意义(P均<0.001);剖宫产组脐动脉血气p H(中位数7.30)优于自然分娩组(中位数7.28)/器械助产组(中位数7.28),差异有统计学意义(P均<0.01);剖宫产组乳酸水平(中位数2.30 mmol/L)优于自然分娩组(中位数4.30 mmol/L)/器械助产组(中位数3.80 mmol/L),差异有统计学意义(P<均0.001);而自然分娩组与器械助产组的脐动脉血气p H、乳酸值比较,差异均无统计学意义(P>0.05)。结论足月孕妇产程中诊断绒毛膜羊膜炎后,缩短产程、器械助产、剖宫产均不能显著改变新生儿出生结局,为改善新生儿血气指标,减少不良事件,应适当放宽剖宫产指征。Objective To investigate the effects of different timing of delivery(time from diagnosis to delivery)and delivery mode on neonatal birth outcomes after full-term pregnant women were diagnosed with chorioamnionitis during labor.Methods The data of 411 full-term pregnant women diagnosed with chorioamnionitis after delivery labor in our hospital from January 2021 to December 2021 were retrospectively analyzed.The effects of different delivery time and mode of delivery on neonatal Apgar score,umbilical artery blood gas pH and lactic acid value,admission to neonatal intensive care unit(NICU),infectious diseases and metabolic acidosis were compared.Results There were no significant differences in Apgar score,umbilical artery blood gas,NICU,infectious diseases and metabolic acidosis among neonates with different delivery time(P>0.05).There were no significant differences in Apgar score,NICU,infectious diseases and metabolic acidosis among neonates with different mode of delivery(P>0.05).The pH of umbilical artery blood gas in cesarean section group(median 7.30)was better than that in vaginal delivery group(median 7.28),and the lactate level in cesarean section group(median 2.30 mmol/L)was better than that in vaginal delivery group(median 4.10 mmol/L),with statistical significance(P<0.001).The pH of umbilical artery blood gas in cesarean section group(median 7.30)was better than that in natural delivery group(median 7.28)/instrumental midwifery group(median 7.28),and the difference was statistically significant(P<0.01).The lactate level in the cesarean section group(median 2.30 mmol/L)was better than that in the natural delivery group(median 4.30 mmol/L)/instrumental delivery group(median 3.80 mmol/L),and the differences were statistically significant(all P<0.001).There were no significant differences in blood gas pH and lactic acid between the natural delivery group and the instrumental delivery group(P>0.05).Conclusions After diagnosis of chorioamniotic infection during labor,shortening labor,instrumental delivery and

关 键 词：绒毛膜羊膜炎 宫内感染 产程中 分娩时间 分娩方式 

分 类 号：R714[医药卫生—妇产科学]