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目的:分析剖宫产术、阴道助产术在足月妊娠临产胎儿窘迫中的应用效果。方法:回顾性的分析2008年10月～2012年10月滨州医学院附属医院产科采用剖宫产术或阴道助产术分娩的存在胎儿窘迫的足月妊娠临产孕妇的病历资料,分别为剖宫产组、阴道助产术组,比较两组出现胎儿窘迫的病因、胎儿先露高低情况、宫口开大情况、围产儿结局。结果:头盆不对称是导致剖宫产组出现胎儿窘迫的主要影响因素,其余依次为滞产、胎头位置异常、头部过期妊娠、臀位胎膜早破、臀位过期妊娠、合并骨盆狭窄。第一产程活跃期延长是导致阴道助产术组胎儿出现胎儿窘迫的主要影响因素,其余依次为胎膜早破、过期妊娠、脐带脱出。剖宫产组S≤+1者显著高于阴道助产术组,S+3显著低于阴道助产术组(P<0.05);两组S+2不存在统计学差异(P>0.05)。剖宫产组潜伏期宫口开大<3cm显著高于阴道助产术组(P<0.05)。剖宫产组共20例新生儿出现不同程度的窒息,占34.48%;阴道助产术组共25例出现不同程度的窒息,占39.06%,两组新生儿窒息率无统计学差异(P>0.05)。结论:采取剖宫产术或阴道助产术对于存在胎儿窘迫的临产孕妇均可获得较好的围产儿结局。
Objective: To analyze the effect of cesarean section and vaginal midwifery on fetal distress in full term pregnancy. Methods: Retrospectively analyzed the medical records of pregnant women with full-term pregnancy with term fetal distress who were delivered by cesarean section or vaginal midwifery from October 2008 to October 2012 in Affiliated Hospital of Binzhou Medical College. The data were cesarean section Production group, vaginal midwifery group, compared the cause of fetal distress in both groups, fetal exposure to the situation, cervix open situation, perinatal outcome. Results: The asymmetry of the tibia was the main factor that led to fetal distress in the cesarean section. The rest were delayed labor, abnormal fetal head position, premature pregnancy in the head, premature rupture of the membranes in the breech, breech pregnancy, combined pelvis narrow. The prolonged active stage of the first stage of labor was the main factor that led to fetus distress in the vaginal delivery group, followed by premature rupture of membranes, expired pregnancy and umbilical cord prolapse. S≤ + 1 in cesarean section group was significantly higher than that in vaginal delivery group, S + 3 was significantly lower than that in vaginal delivery group (P <0.05) . The latent period of cesarean section was significantly shorter than that of vaginal midwifery group (P <0.05). In the cesarean section, a total of 20 newborn infants showed different degree of asphyxia, accounting for 34.48%. There were 25 cases of asphyxia in the vaginal midwifery group, accounting for 39.06%. There was no significant difference in asphyxia between the two groups (P> 0.05). CONCLUSIONS: Caesarean section or vaginal midwifery leads to better perinatal outcomes for pregnant women who have fetal distress.