产时超声对第二产程延长初产妇分娩方式及母婴结局的影响  

Influence of Intrapartum Ultrasound on Delivery Methods and Maternal and Neonatal Outcomes in Primiparas with Prolonged Second Stage of Labor

作　　者：刘秋转 陈世荣 吴柳瑜 LIU Qiuzhuan;CHEN Shirong;WU Liuyu(Department of obstetrics,Guangzhou Women and Children Medical Center,Guangdong Guangzhou 511399)

机构地区：[1]广州市妇女儿童医疗中心产科,广东广州511399

出　　处：《深圳中西医结合杂志》2024年第21期21-24,F0003,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：福建省卫健委科技计划项目(2020TG01010087)。

摘　　要：目的:探讨产时超声对第二产程延长初产妇分娩方式的指导价值,以及对母婴结局的影响。方法:选取2022年7月至2023年12月于广州市妇女儿童医疗中心分娩且出现第二产程延长的初产妇100例作为研究对象。按随机数表法分为对照组和观察组,各50例。对照组行单纯阴道指诊指导分娩,观察组在对照组的基础上行产时超声检查。比较两组产妇分娩方式、产妇结局及新生儿结局。结果:观察组产妇剖宫产、产钳助娩和会阴Ⅲ~Ⅳ度裂伤发生率较对照组低,阴道顺产率较对照组高,产后2 h出血量较对照组更少,差异均具有统计学意义(P<0.05);两组新生儿出生体质量比较,差异无统计学意义(P>0.05);观察组新生儿出生1 min、5 min Apgar评分更高,需呼吸支持及入住新生儿重症监护病房(NICU)的新生儿例数更少,差异均具有统计学意义(P<0.05)。结论:对第二产程延长的初产妇通过阴道指诊联合产时超声指导分娩,可降低剖宫产率,减少产后出血量,改善会阴裂伤程度及新生儿结局。Objective To investigate the guiding value of intrapartum ultrasound in the delivery methods of primiparas with prolonged second stage of labor and its impact on maternal and neonatal outcomes.Methods A total of 100 primiparas with prolonged second stage of labor who delivered at Guangzhou Women and Children Medical Center from July 2022 to December 2023 were selected as the research subjects.They were randomly divided into a control group and an observation group,with 50 cases in each group.The control group was guided by simple vaginal digital examination,while the observation group received intrapartum ultrasound examination in addition to the control group's method.The delivery methods,maternal outcomes,and neonatal outcomes were compared between the two groups.Results The incidence of cesarean section,forceps-assisted delivery,and perineal lacerations of degreesⅢtoⅣin the observation group was lower than that in the control group,with a higher rate of spontaneous vaginal delivery,the amount of postpartum hemorrhage within 2 hours was significantly less in the observation group than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in neonatal birth weight between the two groups(P>0.05).The observation group had higher Apgar scores at 1 and 5 minutes after birth,and fewer neonates required respiratory support and admission to the Neonatal Intensive Care Unit(NICU),with statistically significant differences(P<0.05).Conclusion The guidance of delivery by combining vaginal digital examination with intrapartum ultrasound in primiparas with prolonged second stage of labor can reduce the rate of cesarean sections,decrease the amount of postpartum hemorrhage,improve the degree of perineal lacerations,and enhance neonatal outcomes.

关 键 词：产时超声 阴道指诊 第二产程延长 初产妇 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714[医药卫生—诊断学]