足月临产期胎儿窘迫558例临床分析

Clinical analysis of fetal distress in full term labor in 558 cases

目的探讨足月临产期胎儿窘迫的原因,选择正确的分娩方式。方法回顾性分析足月临产期胎儿窘迫558例的临床资料,比较其发生时间、原因、分娩方式及其新生儿结局。结果 558例足月临产期胎儿窘迫中脐带因素230例,占41.22%,在各种原因中居首位;自然分娩、阴道助产及剖宫产的新生儿Apgar评分比较,无显著性差异(x^2=3.28,P>0.05);3种分娩方式其新生儿结局比较,重度窒息儿及死亡率均无显著性差异(x^2值分别为4.73和5.58,均P>0.05)。结论临产期胎儿窘迫的观察尤为重要,胎儿窘迫在产前、产时早期正确判断,针对其发生原因及时处理,选择正确的分娩方式对降低围产儿死亡率具有重要意义。

Objective To discuss the reasons for fetal distress in full telln labor so as to selec.t correct delivery mode. Methods Retrospective analysis was conducted on the clinical data of fetal distress in 558 cases in full term labor to compare the time and reason of distress, delivery mode and newborn outcomes. Results Of 558 cases with fetal distress, umbilical cord factors were found in 230 cases （41.22%）, which ranked first in all reasons. Among spontaneous delivery, vaginal midwifery and cesarean section, there was no significant difference in newborn Apgar score （X2 = 3.28, P 〉 0.05）. In neonatal outcomes severe asphyxia and mortality were not significantly different in three delivery modes （X2 value was 4.73 and 5.58, respectively, both P 〉 0.05 ）. Conclusion It is important to observe fetal distress in labor. Correct diagnosis of fetal distress before delivery and at early stage of labor, timely treatment and choosing proper delivery mode are vital to reduce the mortality of newborn.