足月妊娠临产胎儿窘迫发生因素及两种手术方式的干预效果分析

摘要

目的：探讨足月妊娠临产胎儿窘迫发生因素及剖宫产术与阴道助产术干预效果。方法2012年10月~2013年10月期间我院接收的104例足月妊娠临产胎儿窘迫产妇随机分为观察组和对照组两组，各52例。对照组产妇均施以阴道助产术，观察组产妇均施以剖宫产术，对比分析两组的胎儿窘迫发生因素及母婴结局。结果两组胎儿窘迫发生因素(胎盘因素、脐带因素、母体因素、胎儿因素或羊水粪染等)比较，差异均无统计学意义(P>0.05)。观察组产后出血、新生儿窒息、缺血缺氧性脑病、胎儿生长受限、产褥感染及低蛋白血症的发生率分别为5.77%、5.77%、3.85%、1.92%、11.54%、9.62%，与对照组的9.62%、7.69%、5.77%、1.92%、7.69%、5.77%相比较，差异无统计学意义(P>0.05)。单因素Logistic回归分析结果显示，脐带、胎盘、胎儿、母体、羊水粪染均是胎儿窘迫的危险因素。两组中均未发生新生儿死亡结局。结论治疗足月妊娠临产胎儿窘迫应用剖宫产术与阴道助产术均能获得较好的母婴结局，应根据产妇具体情况而选择适当的分娩方式。%Objective To investigate the factors of term pregnancy fetal distress at term pregnancy and intervention midwifery cesarean section and vaginal fetal distress. Methods All 104 cases of full-term pregnancy with maternal fetal distress in labor were random divided into observation group and control group from our hospital from October 2012-October 2013, each group had 52 cases. Mothers in the control group were given vaginal midwifery, maternal in the observation group were used cesarean section, fetal distress factors and maternal and neonatal outcomes of two groups were compared and analyzed. Results Fetal distress factor (placenta, umbilical cord factors, maternal factors, fetal factors or amniotic fluid, etc.) of two groups were compared, the difference was not statistically significant (P>0.05). The inci dence of postpartum hemorrhage, neonatal asphyxia, hypoxic ischemic encephalopathy, fetal growth restric-tion,puerperal infection and hypoproteinemia of the observation group were 5.77%,5.77%, 3.85%,1.92%, 11.54%,9.62%,compared with 9.62%, 7.69%, 5.77%, 1.92%, 7.69%, 5.77%in the control group,the difference was not statis-tically significant (P>0.05). Single factor factors Logistic regression analysis results showed that the umbilical cord and placenta, fetal and maternal,amniotic fluid dung are independent risk factors of fetal distress. Multiple factors Logistic regression analysis results showed that fetal and maternal,amniotic fluid dung are independent risk factors of fetal dis-tress. neonatal deaths of two groups did not occur. Conclusion Vaginal delivery applications and cesarean surgery in treatment of fetal distress of full-term pregnancy can get better maternal and neonatal outcomes, should be based on the specific circumstances of women to choose the appropriate mode of delivery.