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中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (02) : 213 -215. doi: 10.3877/cma.j.issn.1673-5250.2013.02.019

所属专题： 文献；

论著

低危产妇住院待产时间与母婴围生结局的相关性研究
李红雨1, 常青1,*,*()   
  1. 1. 400038　重庆，重庆第三军医大学西南医院妇产科
  • 收稿日期:2013-02-25 修回日期:2013-03-17 出版日期:2013-04-01
  • 通信作者: 常青

Correlation Study Between Delivery Time of Low Risk Pregnant Women and Maternal and Perinatal Outcomes

Hong-Yu LI1, Qing CHANG1()   

  1. 1. Department of Obstetrics and Gynecology, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China
  • Received:2013-02-25 Revised:2013-03-17 Published:2013-04-01
  • Corresponding author: Qing CHANG
  • About author:
    (Corresponding author: CHANG Qing, Email: )
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李红雨, 常青. 低危产妇住院待产时间与母婴围生结局的相关性研究[J]. 中华妇幼临床医学杂志(电子版), 2013, 09(02): 213-215.

Hong-Yu LI, Qing CHANG. Correlation Study Between Delivery Time of Low Risk Pregnant Women and Maternal and Perinatal Outcomes[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2013, 09(02): 213-215.

目的

探讨低危产妇住院待产时间对母婴围生结局的影响。

方法

选择2007年1月至2011年12月于本院产科住院分娩的11 180例低危产妇为研究对象，并根据产妇入院情况分为临产组(n＝6288)和待产组(n＝4892)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。比较两组产妇住院待产时间、分娩方式、诱导分娩、产程进展、产后出血量、新生儿Apgar评分等资料。两组产妇一般情况比较，差异无统计学意义(P>0.05)。

结果

两组产妇住院待产时间、剖宫产率及阴道分娩率比较，差异有统计学意义(P<0.05)。两组产妇诱导分娩情况比较，差异也有统计学意义(P<0.05)。待产组活跃期和第二产程较临产组显著延长，产后2 h内出血量较临产组显著增多，而Apgar评分≤7分新生儿比率较临产组显著增高，两组比较，差异均有统计学意义(P<0.05)。

结论

缩短低危产妇住院待产时间有利于降低剖宫产率，改善母婴围生结局。

关键词: 住院待产时间, 分娩方式, 围生结局
Objective

To investigate the influence of the delivery time of low risk pregnant women on maternal and perinatal outcomes.

Methods

From January 2007 to December 2011, 11 180 pregnant women with low labor risk were included in the study, and divided into the true labor group(n=6288) and the false labor group(n=4892) according to their signs and symptoms. Delivery time, mode of delivery, induction of parturition, progress of labor, postpartum hemorrhage and Apgar score of newborns were compared. There was no significant difference in gereral condition between two groups (P>0.05). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Southwest Hospital.Informed consent was obtained from each patient.

Results

There had significant differences between two groups in delivery time, incidence rate of cesarean section and vaginal delivery(P<0.05). There also had significant difference in rate of induction of parturition between two groups(P<0.05). Compared to the true labor group, active period and second stage of labor were significantly longer in the false labor group(P<0.05), volume of postpartum hemorrhage in 2 hours was significantly larger in the false labor group as well(P<0.05). The rate of Apgar score (≤7) of newborns in the true labor group was obviously higher than that of the false labor group(P<0.05).

Conclusions

To shorten the delivery time of low risk pregnant women is helpful to reduce the incidence rate of cesarean section and improve the maternal and perinatal outcomes.

Key words: delivery time, delivery mode, perinatal outcome
表1 两组产妇一般情况比较(±s)
Table 1 Comparison of general condition between two groups (±s)
组别 n 年龄(岁) 身高(cm) 体重(kg) 孕龄(孕周)
临产组 6288 27.4±3.3 162.8±5.1 71.8±7.9 38.9±1.8
待产组 4892 26.8±3.9 163.2±6.3 72.2±6.3 39.6±1.5
t 　 2.202 1.315 1.732 2.080
P 　 0.701 0.445 0.310 0.527
表2 两组产妇住院待产时间和分娩方式比较(±s)
Table 2 Comparison of delivery time and mode of delivery between two groups (±s)
组别 n 住院待产时间(h) 剖宫产[n(%)] 阴道分娩[n(%)]
临产组 6288 20.17±11.62 2207(35.1) 4081(64.9)
待产组 4892 42.08±29.34 2656(54.3) 2236(45.7)
t/χ2 　 10.722 4.054 7.473
P 　 0.021 0.019 0.017
表3 两组产妇诱导分娩情况比较[n(%)]
Table 3 Comparison of induction of parturition between two groups[n(%)]
组别 n 诱导分娩方式
0.5%催产素 25 μg米索前列腺 10 mg控释前列腺E2 人工破膜
临产组 6288 94 (1.5) 0 (0.0) 0 (0.0) 619 (9.8)
待产组 4892 733(15.0) 3424(70.0) 489(10.0) 1076(22.0)
χ2 　 13.532 58.490 20.620 4.732
P 　 0.000 0.000 0.000 0.031
表4 两组产妇产程进展情况比较(min，±s)
Table 4 Comparison of progress of labor between two groups (min，±s)
组别 n 活跃期 第一产程 第二产程 第三产程 总产程
临产组 6288 124.7±61.6 391.7±135.8 59.4±14.1 8.4±3.7 480.8±144.9
待产组 4892 178.3±63.7 400.2±129.4 80.2±21.5 8.8±3.5 500.7±149.4
t 　 4.881 1.630 2.146 1.980 1.062
P 　 0.009 0.145 0.006 0.211 0.310
表5 两组产妇产后出血量比较(mL，±s)
Table 5 Comparison of postpartum hemorrhage between two groups (mL，±s)
组别 n 产后出血量
分娩时 产后1 h 产后2 h
临产组 6288 160.15±36.46 71.29±30.33 41.34±19.26
待产组 4892 181.68±48.74 86.46±32.71 47.35±23.24
t 　 4.044 1.574 0.781
P 　 0.003 0.182 0.424
表6 两组新生儿Apgar评分比较[n(%)，分]
Table 6 Comparison of Apgar score of newborns between two groups[n(%)，分]
组别 n 生后1 min 生后5 min
<4 4～7 8～10 <4 4～7 8～10
临产组 6288 220(3.5) 50(0.8) 6018(95.7) 0(0.0) 126(0.2) 6162(98.8)
待产组 4892 347(7.1) 435(8.9) 4109(84.0) 49(0.1) 186(3.8) 4657(96.1)
χ2 　 5.330 8.987 0.510 0.981 3.940 0.000
P 　 0.021 0.003 0.478 0.322 0.046 0.778
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