宫口开全后剖宫产22例分析

An Analysis of 22 Cesarean Section During the Second Stage of Labor

对我院产科2 0 0 2年5月2 0 0 4年11月间的2 2例宫口开全后剖宫产产妇的资料进行总结分析,结果经t检验、二项分布处理后显示:因相对头盆不称行手术者2 1例(95 .45 % )。2 2例中胎膜早破11例(5 0 % ) ;胎头位置异常18例(81.82 % ) ;脐带异常10例,其中脐带绕颈1周9例(4 0 .91% ) ;活跃期胎头下降速度<0 .86cm /h 14例(63 .64 % )。2 2例宫口开全后剖宫产术中均未采用阴道托头,术后也未发生产褥感染及产褥病率,但住院费用、住院天数、抗生素用药天数均大于同期择期剖宫产。所以我们认为,严密观察产程进展,尤其是活跃期胎头下降速度及宫口开大情况,主动调节分娩四因素使之协调,作出及时而准确的决断,做到“多观察、早发现、及时处理”,可减少宫口开全后剖宫产。

We summarized and analyzed the primary data of the 22 lying-in women who have experienced cesarean section after coming into the second stage of labor in the obstetrics of XiangYa 3rd hospital during May, 2002 to Nov,2004 with t test and binomial distributional analysis, and found that there were 21 women (95.45%) received cesarean section because of relative head unfit pelvis. Premature rupture of membranes occurred in 11 cases(50%); abnormal position of fetal head in 18 cases(81.82%);abnormal cord in 10 cases, which included cord winding neck a circle in 9 cases(40.91%); and descend speed of head<0.86 cm/h in 14 cases(63.64%). All the subjects did not adopt height head through vagina during cesarean section procedures, and neither puerperal infection nor morbidity happened. But the cost, hospital staying days and days with adaptation of anti-bacterial drug of all the subjects were much higher than that of the cases received cesarean section during the same period (P<0.05). We believed that careful monitoring of birth process especially head descent and cervix expand in the active phase, balance the 4 factors that influence the labor, decide at a right time, perform a 'investigate more, get earlier and do in time' job, will reduce cesarean sections after coming into the second stage of labor.