第二产程预防性使用葡萄糖酸钙在降低单胎初产妇产时及产后出血量的作用

The Effect of Prophylactic Use of Calcium Gluconate in the Second Stage of Labor on the Reduction of the Amount of Bleeding during and after parturition

目的:分析第二产程预防性使用葡萄糖酸钙对单胎初产妇产时及产后出血量的影响。方法:随机将2018年8月2019年5月在天津市第一中心医院产科住院的单胎孕足月临产后进入第二产程的孕妇分为治疗组(282例)和对照组(274例),治疗组在第二产程预防性给予静脉滴注1 g葡萄糖酸钙,对照组孕妇在进入第二产程后立即给予静脉滴注葡萄糖注射液。比较2组孕产妇的分娩结局和新生儿结局。结果:治疗组第二、三产程时间比对照组短,差异均有统计学意义(均P<0.05)。治疗组的产时出血量和产后2 h、6 h、12 h、24 h出血总量均低于对照组,差异均有统计学意义(均P<0.05)。2组新生儿体质量、新生儿脐动脉血pH值、新生儿1 min Apgar评分和新生儿脐动脉血钙浓度比较,差异均无统计学意义(均P>0.05)。结论:第二产程预防性使用葡萄糖酸钙可降低单胎初产妇产时及产后24 h内出血总量。

Objective:To analyze the effect of prophylactic use of calcium gluconate in the second stage of labor on the reduction of the amount of bleeding during and after parturition.Methods:Patients who entered the second stage of labor in single-birth primipara with hospitalization in the Department of Obstetrics,Tianjin First Central Hospital from August 2018 to May 2019 were randomly divided into two groups,including the treatment group(282 women who accepted 1 g calcium gluconate as the preventive dose usage immediately entering the second stage of labor)and the control group(274 women who accepted glucose injection immediately entering the second stage of labor).The delivery outcomes and the neonatal outcomes were compared.Results:The duration of the second and third stage of labor in the treatment group were both shorter than in the control group with statistically significant(P<0.05).The amount of intrapartum hemorrhage,the total amount of hemorrhage after postpartum 2 h,6 h,12 h and 24 h in the treatment group were all obviously less than that in the control group with statistically significance(P<0.05).All the differences of the neonatal weight,neonatal umbilical artery pH,neonatal 1 min Apgar score and neonatal calcium concentration of umbilical artery blood between the treatment group and the control group were not statistically significant(P>0.05).Conclusions:Preventive use of calcium gluconate when immediately entering the second stage of labor can reduce the amount of intrapartum and postpartum hemorrhage in single-birth primipara.