手扩宫颈处理活跃期胎儿窘迫49例临床分析

Clinical Analysis of 49 Cases of Labor with Fetal Distress and Requiring Cervical Dilation

目的探讨手扩宫颈处理活跃期胎儿窘迫的临床效果和对母婴结局的影响。方法回顾性分析我院2年住院分娩中活跃期发生胎儿窘迫产妇92例,分为干预组(49例)和对照组(43例)。干预组于宫口扩张≥5cm时应用手扩宫颈处理,直至宫口开全,对照组不加任何处理,分别记录两组活跃期时限(5～10cm)、第二产程及总产程、分娩方式、产后出血、宫颈裂伤、新生儿窒息及头颅血肿情况。结果干预组活跃期时限(5～10cm)、第二产程及总产程均比对照组明显缩短(P<0.001),剖宫产率明显低于对照组(P<0.01)。比较两组产后出血、宫颈裂伤、新生儿窒息及头颅血肿发生率差异均无统计学意义(P>0.05)。结论手扩宫颈处理活跃期胎儿窘迫可以缩短产程、降低剖宫产率,对母婴是安全、有效、可行的。

Objective To investigate the clinical outcome of laboring requiring cervical dilation and under the condition of fetal distress in active phase.Methods In the past 2 years,92 cases in this hospital with fetal distress in active phase were retrospectively analyzed.The patients were divided into the intervention group（49 patients）and control group（43 patients）.Patients in the intervention group with the size of cervical of 5 cm or above was manually expanded until the opening reached its mouth width.Patients in the control group received no treatment.Parameters,such as the duration of active period（5～10 cm）,the second stage of labor,the total stage of labor,mode of delivery,postpartum hemorrhage cervical laceration,neonatal asphyxia and hematoma of the skull,were recored.Results The duration of active period（5～10 cm）,the second stage of labor and total stage of labor in the intervention group were significantly shortened than those in the control group（P〈0.001）.Cesarean section rate in the intervention group was significantly lower than that in the control group（P〈0.01）.Postpartum hemorrhage,cervical laceration,neonatal asphyxia and cranial hematoma incidence were not significantly difference between these two groups（P 〉0.05）.Conclusion Manually dilation of cervice can shorten the duration of laboring and lower the cesarean section rate.It is feasible,safe and effective for both the newborn baby and the mothers.