断脐时间、方式对母儿结局的影响

发布时间：2018-12-09 12:06

【摘要】：目的观察断脐时间和方式对母儿结局的影响。方法将670例产妇随机分为早断脐组(即胎儿娩出后10 s内断脐)330例和晚断脐组(待脐带搏动自行停止后断脐)340例,再将晚断脐组分为两个亚组即新生儿高于胎盘平面组(新生儿置于高于胎盘平面的母亲腹部断脐)180例和新生儿低于胎盘平面组(新生儿置于低于胎盘平面的母亲两腿间断脐)160例。比较早断脐组和晚断脐组及两个晚断脐亚组产后出血量、第三产程时间、胎盘粘连及剥离不全发生率、产妇泌乳时间,以及新生儿Apgar评分、体温、胆红素峰值、脐血和出生24 h后外周血血红蛋白、新生儿贫血及病理性黄疸发生情况。结果晚断脐组新生儿出生24 h后外周血血红蛋白及胆红素峰值明显高于早断脐组(两组相比,P均0.05),产后出血量、第三产程时间、新生儿贫血发生率明显低于早断脐组(两组相比,P均0.05)。新生儿高于胎盘平面组的新生儿体温明显高于新生儿低于胎盘平面组(两组相比,P0.05),泌乳时间短于新生儿低于胎盘平面组(两组相比,P0.05)。结论晚断脐比早断脐更加减少产后出血量、缩短第三产程、增加新生儿血红蛋白、减少新生儿贫血发生率且不增加新生儿病理性黄疸发生率;将新生儿置于高于胎盘平面的母亲腹部断脐更有利于新生儿保暖,促进母亲泌乳。
[Abstract]:Objective to observe the effect of umbilical disconnection time and mode on maternal and fetal outcomes. Methods 670 cases of parturient were randomly divided into three groups (330 cases of early umbilical cord cut off group (10 seconds after delivery) and 340 cases of late umbilical cord cut off group (after cord pulsatility stopped). The late umbilical cord group was further divided into two subgroups: 180 newborns above placental level (mothers with newborns placed above placental level) and 180 newborns with lower placental levels (mothers with newborns placed below placental level). There were 160 cases with discontinuous umbilical cord on both legs. The volume of postpartum hemorrhage, the time of the third stage of labor, the incidence of placental adhesion and incomplete exfoliation, the lactation time of parturient, the Apgar score of newborn, the body temperature and the peak bilirubin were compared. Umbilical cord blood and peripheral blood hemoglobin, neonatal anemia and pathological jaundice occurred 24 hours after birth. Results the peak value of hemoglobin and bilirubin in peripheral blood of newborns 24 hours after birth were significantly higher than those in early umbilical cord disconnection group (P 0.05), postpartum hemorrhage volume and the time of the third stage of labor were significantly higher than those in the early umbilical cord group (P 0.05). The incidence of anemia in neonates was significantly lower than that in early amputation group (P 0.05). The temperature of newborns higher than placenta level group was significantly higher than that of newborns lower than placental level group (P0.05), and the lactation time was shorter than that of placental level group (P0.05). Conclusion the amount of postpartum hemorrhage, the third stage of labor, the hemoglobin of the newborn, the incidence of anemia and the incidence of pathological jaundice of the newborn are reduced by the late umbilical cord cut off than the early umbilical cord. It is more beneficial to keep the newborn warm and promote the mother's lactation by placing the newborns above the placental level.
【作者单位】：郑州大学第三附属医院;
【分类号】：R714.3

【参考文献】