引用本文
  • 周建新,王小新,姜海利.足月初产妇产钳助产的产程时限特征[J].同济大学学报(医学版),2020,41(2):240-244.    [点击复制]
  • ZHOU Jian-xin,WANG Xiao-xin,JIANG Hai-li.Characteristics of stages of labor in full-term primiparouswomen with forceps delivery[J].同济大学学报(医学版),2020,41(2):240-244.   [点击复制]
【打印本页】 【在线阅读全文】【下载PDF全文】 查看/发表评论下载PDF阅读器关闭

←前一篇|后一篇→

过刊浏览    高级检索

本文已被:浏览 14次   下载 17 本文二维码信息
码上扫一扫!
足月初产妇产钳助产的产程时限特征
周建新,王小新,姜海利
0
(首都医科大学附属北京妇产医院产科,北京100026)
摘要:
目的分析实施产钳助产的妊娠足月初产妇产程时限特点以及对妊娠结局的影响。方法选取2016年1月1日—2016年12月31日在首都医科大学附属北京妇产医院单中心分娩的15194例产妇,37周后分娩13692例,其中产钳助产706例均为单胎初产妇。根据第二产程时间分组,≥2h例为观察组(n=132),<2h(n=574)为对照组,进行回顾性分析。结果妊娠37周后,剖宫产率为30.7%(4204/13692),产钳助产率8.1%(767/9488)。产钳助产分娩中,产后出血率、会阴Ⅲ度裂伤发生率、新生儿窒息率分别为34.7%(245/706)、0.2%(2/706)和4.7%(33/706),第一产程、第二产程、总产程时间分别为(10.41±5.48)、(1.10±0.90)和(11.61±5.73)h。观察组的第一产程、第二产程为、总产程显著长于对照组[(13.00±5.99) vs (9.87±5.09)h、(2.68±0.48) vs (0.74±0.49)h、(15.81±6.01) vs (10.70±5.23)h,均P<0.05];观察组中,产后出血(>500mL)发生率48.5%(64/132),明显高于对照组的30.1%(173/574),而严重产后出血(≥1000、1500mL)差异无统计学意义。多因素logistic回归分析显示,年龄增长、发生胎膜早破、新生儿体重增加、进行分娩镇痛是第二产程时间超过2h的危险因素。结论产钳助产分娩的产程时限并未明显延长,识别高危因素,控制第二产程时间可以减少产后出血的发生。
关键词:  产钳助产分娩  产程时限  危险因素  分娩结局
DOI:10.16118/j.1008-0392.2020.02.017
投稿时间:2019-12-10
基金项目:首都医科大学附属北京妇产医院中青年学科骨干培养专项(FCYY201912)
Characteristics of stages of labor in full-term primiparouswomen with forceps delivery
ZHOU Jian-xin,WANG Xiao-xin,JIANG Hai-li
(Dept. of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China)
Abstract:
ObjectiveTo analyze the characteristics of the stage of labor in full-term primiparous women with forceps delivery and the impact on the pregnancy outcomes. MethodsThe clinical data of 706 full-term primiparous women with singleton pregnancy undergoing forceps delivery in Beijing Obstetrics and Gynecology hospital, Capital Medical University between January 2016 and December 2016, were retrospectively analyzed. There were 132 cases with the second stage ≥2h(observation group) and 574 cases with the second stage <2h(control group). ResultsThe overall incidence of postpartum hemorrhage, perineal grade Ⅲ laceration, and neonatal asphyxia were 34.7%(245/706), 0.2%(2/706), and 4.7%(33/706), respectively; and the first stage of labor, the second stage of labor, and the total stage of labor were (10.41±5.48), (1.10±0.90) and (11.61±5.73) h, respectively. In the observation group, the first stage of labor was (13.00±5.99) h, the second stage was (2.68±0.48) h, and the total stage of labor was (15.81±6.01) h, which were significantly longer than those in the control group [(9.87±5.09), (0.74±0.49) and (10.70±5.23)h, respectively; P<0.05]. In the observation group, the incidence of postpartum hemorrhage was 48.5%(64/132), which was significantly higher than that of the control group(30.1%, 173/574). However, there was no significant difference in the proportion of cases with postpartum hemorrhage ≥1000 and 1500 mL. The multivariate logistic regression showed that the maternal age, premature rupture of membranes, neonatal weight and labor analgesia were the risk factors for the prolonged second stage more than 2 hours. ConclusionThe overall stage of labor in forceps delivery is not significantly prolonged. However, the prolonged second stage of labor may increase the incidence of postpartum hemorrhage, which can be reduced by identification of risk factors to shorten the second stage of labor.
Key words:  forceps delivery  stage of labor  risk factors  pregnancy outcomes

您是第2025735位访问者
版权所有《同济大学学报(医学版)》编辑部
主管单位:教育部 主办单位:同济大学
地  址: 上海四平路1239号 邮编:200092 电话:021-65980705 E-mail: yxxb@tongji.edu.cn
本系统由北京勤云科技发展有限公司设计