活跃期起始点改变对产程处理的影响

发布时间：2018-03-17 20:00

本文选题：活跃期　切入点：产程　出处：《中国妇产科临床杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的探讨活跃期起始点改变对产程处理的影响。方法回顾性分析2009年1月—12月北京大学第一医院分娩的1 641例初产妇的临床资料。结果阴道分娩组宫口开大3、4、5、6cm为活跃期起始点,平均活跃期时间分别为(4.4±2.1)h、(3.0±1.9)h、(2.1±1.4)h和(1.4±0.9)h,差异均有统计学意义(P0.01)。不同起始点各组平均第二产程时间和新生儿出生体质量比较,差异无统计学意义(P0.05)。阴道分娩组宫口开大3、4、5、6cm活跃期停滞发生率分别为25.3%(198/784)、10.7%(26/243)、4.4%(5/113)和0。剖宫产组宫口开大3、4、5、6cm活跃期停滞发生率分别为55.7%(78/140)、46.2%(18/39)、5/15和2/3。宫口开大6cm发生活跃期停滞者330例,其中229例阴道分娩(69.4%)。单纯以活跃期停滞为剖宫产手术指征者占40%(82/205),其中73.2%(60/82)为宫口开大3cm。结论宫口开大6cm之前活跃期停滞者,仍有阴道分娩机会;活跃期起始点改变可减少宫口开大3cm停滞者行剖宫产的比例。
[Abstract]:Objective to investigate the effect of the change of the starting point of active phase on the treatment of labor. Methods the clinical data of 1 641 primipara delivered in Peking University first Hospital from January 2009 to December were analyzed retrospectively. The mean active period time was 4.4 卤2.1 h and 1.4 卤0.9 h, respectively, and the mean duration of the second stage of labor and the birth weight of the newborns at different starting points were significantly higher than those in the control group. The average time of the second stage of labor and the birth weight of the newborns were significantly higher than those of the control group (P < 0.05), and the difference was statistically significant (P < 0.05). There was no significant difference between the two groups (P 0.05). The incidence of active stagnation in the vaginal delivery group was 25. 3% and 25. 3% respectively. The incidence of active stagnation in the vagina delivery group was 25. 3% and 25. 3% respectively. In the caesarean section group, the incidence of active stagnation in the open opening of the uterus was 55.775 cm. The incidence of active stagnation in the vaginal delivery group was 55.7m, 78140cm, 46.218.1% 515 and 23%, respectively. There were 330 cases of active stagnation in the caesarean group with the opening of the uterus opening 6cm. There were 229 cases of vagina delivery with 69.4% of them. Only active stagnation was the indication of cesarean section (4082 / 205), of which 73.2 / 82 (60 / 82) was dilated for 3 cm. Conclusion there is still a chance of vaginal delivery for those with stagnation in active period before the opening of uterine mouth is 6 cm. The change of the starting point of active stage can reduce the proportion of cesarean section in the patients with 3 cm stagnation of opening.
【作者单位】：北京大学第一医院妇产科;安徽省马鞍山市十七冶医院妇产科;
【分类号】：R714

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