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目的探讨羊水污染与新生儿预后的关系。方法对154例患儿中足月头位产儿根据羊水污染的程度,将羊水污染分为3度。观察其新生儿预后情况。结果154例患儿中新生儿窒息29例,发生率18.83%,6例5分钟Apgar评分低于或等于5分,1分钟Apgar评分均低。2例患儿确诊为胎粪吸入综合征(MAS),其中1例死亡。新生儿预后与羊水胎粪污染程度:Ⅲ度污染者新生儿预后不良的发生率明显增高,Ⅰ度与Ⅲ度,Ⅱ度与Ⅲ度粪污染之间差异均有统计学意义(P<0.05),但Ⅰ度与Ⅱ度粪污染之间差异无统计学意义(P>0.05)。结论羊水Ⅲ度污染的胎儿有明显缺氧,应尽快终止妊娠或结束分娩;Ⅰ度与Ⅱ度粪污染者应加强胎心电子监护,不必过早干预,以免扩大剖宫产率或增加各种手术助产所导致的并发症。
Objective To investigate the relationship between amniotic fluid contamination and the prognosis of neonates. Methods According to the degree of amniotic fluid contamination in 154 cases of full-term newborn babies, amniotic fluid contamination was divided into 3 degrees. Observe the prognosis of their newborns. Results Among the 154 children, 29 were neonatal asphyxia at a rate of 18.83%. Apgar scores were lower than or equal to 5 at 6 minutes, and Apgar scores at 1 minute were lower. Two patients were diagnosed as meconium aspiration syndrome (MAS), of which 1 died. Neonatal prognosis and amniotic fluid meconium contamination: Ⅲ degree polluters newborns with poor prognosis were significantly higher, Ⅰ degree and Ⅲ degree, Ⅱ degree and Ⅲ degree of fecal contamination were significantly different (P <0.05) , But there was no significant difference between Ⅰ degree and Ⅱ degree fecal contamination (P> 0.05). Conclusion Amniotic fluid Ⅲ degree of pollution of the fetus with significant hypoxemia, termination of pregnancy or termination of labor as soon as possible; Ⅰ degree and Ⅱ degree fecal contamination should be enhanced fetal heart monitoring without the need for premature intervention, so as not to expand the cesarean section rate or increase various Complications due to midwifery.