减少第二产程剖宫产,降低母婴并发症—附312例病例分析

Decrease cesarean section in the second stage,reduce maternal and neonatal complications——Analysis of 312 cases attached

目的探讨正确处理第一产程,减少第二产程剖宫产,降低母婴并发症。方法总结2011年5月-2012年5月我院产程中剖宫产212例,其中第一产程异常经积极处理后行剖宫产112例(研究组),第二产程剖宫产100例(观察组),择期剖宫产100例为对照组。结果第二产程剖宫产子宫切口延裂率16.0%,产后出血率14.0%,产褥感染率9.0%,均高于研究组的4.46%,3.57%,1.79%(P<0.05)。观察组新生儿窒息率10.0%,羊水粪染率19.0%,新生儿入NICU率8.0%,均高于研究组的2.68%,7.14%,1.79%(P<0.05);而以上各比率在研究组与对照组间无显著性差异。结论第二产程剖宫产对于母婴的危险系数都远高于第一产程剖宫产,临床医生应注意正确处理第一产程,防止试产过度,尽量减少第二产程剖宫产。

Objective： To investigate the effects on maternal and neonates during cesarean delivery in the second stage of labor.Methods： A retrospective study was performed to analyze the 212 patients who delivered by cesarean section during May 2011 to May 2012 in our hospital.Among them,112 cases terminated pregnancy by cesarean section in the first stage of labor（study group）,100 cases terminated pregnancy in the second stage of labor（observation group）,and 100 cases received selective cesarean section（control group）.Results： The rates of extended laceration of the uterine incision,postpartum hemorrhage and puerperal infection in the observation group were 16%,14%,and 9.0% respectively,which were much higher than that in the study group,which were 4.46%,3.57%,1.79%;and they were statistically different between the two groups（P 0.05）.The rates of neonatal asphyxia,meconium-stained amniotic fluid,and newborns into the NICU in the observation group were 10%,19%,8%,respectively,which were much higher than that in the study group,which were 2.68%,7.14%,1.79%;and they were statistically different between the two groups（P 0.05）.But there were no statistical differences between the study group and the control group（P 0.05）.Conclusions： The risks during cesarean section in the second stage of labor were much higher than those in the first stage of labor.Clinical doctors should pay special attention on correct treatment of labor process,avoid excessive trial of labor,and reduce cesarean section in the second stage to reduce maternal and neonatal complications.