分娩方式对重度妊高症合并胎儿生长受限新生儿脐血血气指标及妊娠结局的影响

Influence of different delivery mode on neonatal cord blood gas index and pregnancy termination in patients with severe hypertensive disorders of pregnancy combined fetal growth restriction

目的:探讨分娩方式对重度妊高症合并胎儿生长受限的新生儿脐血血气指标以及妊娠结局的影响。方法:132例重度妊高症合并胎儿生长受限患者根据分娩方式分为经阴分娩组(n=68)与剖宫产组(n=64),分别检测两组新生儿脐动脉、脐静脉血pH、CO2分压(PCO2)、HCO3-、碱剩余(BE)以及血细胞比容(HCT)等指标,比较两组新生儿出生体重、新生儿窒息发生率、围产儿死亡率以及产妇并发症发生率。结果:经阴分娩组新生儿脐动脉血pH显著低于剖宫产组(P<0.01),PCO2显著高于剖宫产组(P<0.01),而PO2、HCO3-、BE以及HCT在两组之间比较未见统计学差异(P>0.05);两组新生儿脐静脉血pH、PCO2、PO2、HCO3-、BE以及HCT比较均无统计学差异(P>0.05)。经阴分娩组新生儿出生体重显著低于剖宫产组(P<0.01),新生儿窒息、围产儿死亡以及产妇并发症发生率均显著高于剖宫产组(P<0.05)。结论 :适时剖宫产能够迅速使胎儿脱离缺氧环境,降低围产期母儿不良后果的发生率,对于重度妊高症合并胎儿生长受限者,剖宫产指征应适当放宽,以保证母儿安全。

Objective： To explore the influence different delivery mode on neonatal cord blood gas index and pregnancy termination in patients with severe hypertensive disorders of pregnancy combined fetal growth restriction. Methods： A total of 132 patients with severe hypertensive disorders of pregnancy combined fetal growth restriction were divided into the vaginal delivery group（n=68） and the cesarean delivery group（n=64）, pH, PCO2 , HCO3- , BE, and HCT of the umbilical artery and umbilical vein were detected and contrasted, the pregnancy termination of the two groups were contrasted. Results： pH of the umbilical artery in the vaginal delivery group was significantly lower than the cesarean delivery group（P〈0.01）, PCO2 signifi- cantly higher than the cesarean delivery group（P〈0.01）. There was no significantly difference in PO2, HCO3 , BE, and HCT of the umbilical artery between two groups（P〉0.05） ; no significantly difference in pH, PCO2 , PO2 , HCO3 , BE, and HCT of the umbilical vein between the two groups（P〉0.05）. Neonate birth weight in the vaginal delivery group was signifi- cantly lower than the cesarean delivery group（P〈0.01）, The incidence of Neonatal asphyxia, perinatal death, and maternal complications in the vaginal delivery group was significantly higher than the cesarean delivery group（P〈0. 05）. Conclusion：Timely cesarean section can quickly protect fetus from anoxic environment, reduce the incidence of maternal and infant bad con- sequence perinatal. For patients with severe hypertensive disorders of pregnancy combined fetal growth restriction, the cesare- an section indications should be adjusted, to ensure the safety of maternal and infant.