不同分娩方式对低危产妇母婴围生期结局的影响

发布时间：2017-12-31 13:31

本文关键词：不同分娩方式对低危产妇母婴围生期结局的影响　出处：《中华妇幼临床医学杂志(电子版)》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨经阴道与剖宫产分娩,对低危产妇母婴围生期结局的影响。方法选取2014年12月,至2015年12月于第三军医大学西南第一附属医院产科住院分娩的948例低危产妇为研究对象。按照低危产妇分娩方式,将其分为阴道分娩组(n=474,采用经阴道自然分娩方式)和剖宫产分娩组(n=474,采用子宫下段剖宫产术分娩)。统计学比较2组产妇产后24h出血量、产后出血(PPH)发生率、新生儿Apgar评分、新生儿窒息发生率和新生儿脐带血免疫球蛋白(Ig)A、G、M及C反应蛋白(CRP)水平等免疫功能指标。本研究通过医院伦理委员会审查,并与所有产妇及其家属均签署知情同意书。结果①2组产妇年龄、孕龄,以及其分娩新生儿的体重、性别构成比等一般临床资料比较,差异均无统计学意义(P0.05)。②阴道分娩组产妇产后24h出血量及PPH发生率均低于剖宫产分娩组,差异均有统计学意义(t=7.261,P=0.016;χ~2=4.934,P=0.021)。③2组产妇分娩新生儿出生1、5min时,Apgar评分、窒息发生率分别比较,差异均无统计学意义(P0.05)。阴道分娩组产妇分娩新生儿的脐带血IgG、IgM水平,均显著高于剖宫产分娩组,CRP水平则显著低于剖宫产分娩组,差异均有统计学意义(t=2.973,P=0.043;t=3.755,P=0.039;t=4.825,P=0.006)。2组产妇分娩新生儿的脐带血IgA水平比较,差异无统计学意义(P0.05)。剖宫产分娩组产妇所分娩新生儿中,男性新生儿脐带血IgG水平显著低于女性新生儿,差异有统计学意义(t=3.852,P=0.040);男、女性新生儿脐带血IgA、IgM、CRP水平,以及阴道分娩组产妇所分娩的男、女性新生儿脐带血IgA、IgG、IgM、CRP水平分别比较,差异均无统计学意义(P0.05)。结论阴道分娩较剖宫产分娩可减少低危产妇产后24h出血量,降低PPH发生率,提高新生儿免疫功能,利于母婴健康。
[Abstract]:Objective to investigate the effect of vaginal delivery and cesarean section on perinatal outcome of low risk women. Methods December 2014 was selected. From December 2015 to December 2015, 948 low-risk parturients in the first affiliated Hospital of Southwest China military Medical University were studied according to the delivery mode of low-risk parturient. They were divided into vaginal delivery group and caesarean delivery group. The volume of postpartum hemorrhage, the incidence of postpartum hemorrhage and the Apgar score of newborns were compared statistically. The incidence of neonatal asphyxia and the levels of immunoglobulin (IGG) and C-reactive protein (CRP) in umbilical cord blood of neonates were examined by the Hospital Ethics Committee. Results the age, gestational age, birth weight and sex ratio of newborns in 12 groups were compared. There was no significant difference in blood loss and PPH incidence in vaginal delivery group (P 0.05.2) compared with caesarean delivery group (P 0.052.The difference was statistically significant (P 0.052.The incidence of postpartum hemorrhage and PPH was 7.261). P0. 016; The Apgar score and the incidence of asphyxia were compared at 1 to 5 minutes after birth in the puerpera group (蠂 2 / 4.934) P 0.021 (n = 32). There was no significant difference between the two groups (P 0.05). The level of IgM in umbilical cord blood of parturient in vaginal delivery group was significantly higher than that in caesarean delivery group. The level of CRP was significantly lower than that of caesarean delivery group (P 0.043). Tet 3.755Pu 0.039; There was no significant difference in IgA level of umbilical cord blood between pregnant women and newborns delivered by cesarean section (P 0.05). The level of IgG in umbilical cord blood of male newborns was significantly lower than that of female newborns (P 0.040). The levels of IgA- IgMU CRP in umbilical cord blood of male and female newborns, and those of male and female newborns in vaginal delivery group were compared respectively. Conclusion vaginal delivery can reduce the amount of postpartum hemorrhage, reduce the incidence of PPH and improve the immune function of newborns compared with caesarean delivery. It is good for mother and child health.
【作者单位】：第三军医大学西南第一附属医院妇产科;
【基金】：重庆市科学技术协会基金项目(WX2015-005)~~
【分类号】：R714.7
【正文快照】： 作者单位:400038重庆,第三军医大学西南第一附属医院妇产科2006年美国国立卫生研究院与美国妇产科协会提出,产妇选择性剖宫产(cesarean delivery onmaternal request,CDMR)是指在无阴道分娩禁忌证情况下,单胎妊娠产妇临产前要求采取剖宫产方式分娩[1]。我国CDMR占所有剖宫产分

【相似文献】