胎儿窘迫孕妇剖宫产126例分析

Cesarean Section in 126 Cases of Fetal Distress

目的:探讨因胎儿宫内窘迫而行剖宫产的指征,降低新生儿窒息率及围生儿死亡率,为今后因胎儿宫内窘迫合理掌握剖宫产指征提供科学依据。方法:将我院因胎儿宫内窘迫行剖宫产的孕妇126例,按胎儿电子监护、羊水情况分为3组,并与术中所见胎儿宫内窘迫相关因素及新生儿Apgar评分对照。结果:I组新生儿Apgar评分≤7分发生率为6.66％,Ⅱ组新生儿Apgar评分≤7分发生率为25％,Ⅲ组新生儿Apgar评分≤7分发生率为6.15％,从结果看Ⅱ组明显高于Ⅰ组、Ⅲ组之和。结论:如胎心异常与羊水污染同时存在,胎儿存在或潜在存在缺氧情况,应及时娩出胎儿。单纯胎心异常或单纯羊水污染应根据有无伴随高危因素、产程进展,严密监护下按胎儿窘迫处理决定剖宫产或阴道分娩。

Objective: To investigate the indication of cesarean section in fetal distress and reduce the newborns asphyxia rate and perinatal mortality rate. Methods: Cesarean section performed in 126 cases with fetal distress was analyzed. According to the abmormalities of fetal heart monitoring and amniotic fluid, 126 cases were divided into three groups. Factors associated with fetal distress by finding during operation and Apgar score of newborns were studied in each group. Results: The low Ap-gar score (≤7) rate of newborns was 6.66% , 25% , and 6.15% in group I , Group Ⅱ, and Group Ⅲ respectively. The dif-ferences between group II and two other groups were significant. Conclusion: Hypoxia or underlying hypoxia most likely ex-ists in patient complicated with abnormalities of fetal heart rate and stained amniotic fluid. Therefore rapid delivery is the best choice. Under close observation and monitoring, pregnancy and trial labor might continue in patient only with abnormalities of fetal heart rate or stained amniotic fluid with exception of patient complicated with high risk factors and (or) labor not finish-ing within 1-2 hours.