孕妇羊水Ⅲ度浑浊分娩方式与母儿预后的关系

Relationship between delivery methods of pregnant women with Ⅲ degree of amniotic fluid contamination and maternal and their children’s prognosis

目的探讨羊水Ⅲ度浑浊的孕妇选取不同分娩方式对母儿的影响。方法将2014年6月至2018年6月就诊于宁德市医院产科择期手术中羊水Ⅲ浑浊的孕妇及其新生儿作为研究组,共716例;将同期第二产程中胎膜破裂发现羊水Ⅲ浑浊并顺产的孕妇及其新生儿作为对照组,共860例,分析不同分娩方式对母儿结局的影响。结果研究组新生儿窒息发生率(9.22%vs.13.49%)、酸中毒发生率(12.15%vs.16.16%)、新生儿感染率(7.26%vs.11.16%)均低于对照组,差异均有统计学意义(χ^2值分别为6.98、5.12、6.97,均P<0.05);研究组新生儿病理性黄疸发生率(14.94%vs.18.02%)、母体切口甲级愈合率(95.67%vs.94.88%)与对照组比较差异均无统计学意义(χ^2值分别为2.67、0.91,均P>0.05)。结论羊水Ⅲ度浑浊时顺产的新生儿发生窒息、酸中毒的比例高,感染增多,在临床上应注意选择合适的分娩方式。

Objective To explore the influence of different delivery methods of pregnant women with Ⅲ degree of amniotic fluid contamination on maternal and their children’s prognosis.Methods A total of 716 pregnant women with Ⅲ degree of amniotic fluid contamination admitted in Ningde Hospital Affiliated to Fujian Medical University and taken caesarean section from June 2014 to June 2018 were selected as the study group.At the same time,a total of 860 pregnant women with Ⅲ degree of amniotic fluid contamination and taken natural labor were selected as the control group.And then,the influence of different delivery methods on maternal and their children’s outcomes was analyzed.Results The incidence of neonatal asphyxia(9.22% vs. 13.49%),acidosis(12.15% vs. 16.16%) and neonatal infection(7.26% vs.11.16%) in the study group were all lower than the control group,and the differences were statistically significant(χ^2=6.98,5.12 and 6.97,respectively,all P<0.05).But no significant difference was found in the incidence of pathological jaundice of newborn(14.94% vs. 18.02%) and the rate of maternal incision healing(95.67% vs. 94.88%) between the study group and control group(χ^2=2.67 and 0.91,respectively,both P>0.05).Conclusion The proportion of neonatal asphyxia and acidosis in pregnant women with II degree of amniotic fluid contamination and natural labor is high,and the infection is increased.It should be used as an important reference index to guide the mode of delivery.