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目的 探讨第三产程中胎盘剥离的生理过程和适宜时间。方法 应用彩色超声诊断仪 ,观察第三产程中胎盘剥离过程的动态变化 ;以称重法计算产后 2h内的出血量。结果 第三产程中胎盘剥离过程可分为 4个时期 :潜伏期、收缩期、分离期、排出期 ;各期持续时间为 :潜伏期 (4 37±3 78)min ,收缩期 (1 4 8± 0 97)min ,分离期 (0 5 0± 0 0 0 )min ,排出期 (0 6 2± 0 2 3)min。约 85 %的产妇第三产程均在 10min以内结束 ,平均 6 94min。第三产程超过 10min者 ,阴道出血量显著增加 (P <0 0 1) ,发生各种并发症的危险性也相应增加。结论 为预防产后出血 ,第三产程以不超过 10min为宜。
Objective To investigate the physiological process of placental detachment during the third stage of labor and its suitable time. Methods The color ultrasonic diagnostic apparatus was used to observe the dynamic changes of placental detachment during the third stage of labor. The amount of bleeding within 2 hours after delivery was calculated by the method of weighing. Results The process of placental detachment in the third stage of labor was divided into four phases: incubation period, systole period, septation period and excretion period. The duration of incubation period was (4 37 ± 3 78) min and systolic period (14 8 ± 0) 97) min, the period of separation (0 50 ± 0 0 0) min and the period of discharge (0 62 ± 0 2 3) min. About 85% of the third trimester of the mothers ended within 10min, an average of 694min. The third stage of labor more than 10min, vaginal bleeding increased significantly (P <0 01), the risk of various complications also increased accordingly. Conclusion To prevent postpartum hemorrhage, the third stage of labor should not exceed 10min.