缩短急诊剖宫产自决定手术至胎儿娩出时间对胎儿的影响

Shorten the Impact of Emergency Cesarean Section Self-decision Operation to Fetal Delivery Time on the Fetus

目的探讨缩短急诊剖宫产自决定手术至胎儿娩出时间(decision to delivery interval,DDI)对胎儿预后的影响效果。方法选取2019年9月—2020年6月我院产房收治的经剖宫产孕产妇171例,通过随机数字表法分组,对照组100例,研究组71例。对照组-同期胎儿窘迫,胎心稍偏快或胎心减速后能恢复正常,需行剖宫产终止妊娠,即急诊剖宫产组。研究组-急性胎儿窘迫胎心持续减速3 min以上不能恢复或胎盘早剥阴道出血多、胎心改变,即优化后的急诊剖宫产组。对两组产妇的DDI和DDI各阶段时间进行对比,同时观察两组产妇预后情况和新生儿预后情况。结果研究组DDI和DDI各阶段时间均短于对照组,比较差异均有统计学意义(P<0.05);研究组胎儿预后情况与对照组比较差异无统计学意义(P>0.05)。结论在产妇阴道试产过程中出现急性胎儿窘迫、胎盘早剥等紧急情况时,应用缩短急诊剖宫产自决定手术至胎儿娩出时间措施,能够有效缩短DDI时间,从而降低新生儿窒息率,改善母儿预后,在临床上值得进一步应用推广。

Objective To investigate the effect of shortening the time between emergency cesarean section delivery and delivery of the fetus.The distinction and delivery of the DDI affect fetal prognosis.Methods A total of 171 cases of caesarean delivery women admitted to the delivery room of our hospital from September 2019 to June 2020 were selected and divided into group by random number method,100 cases in the control group and 71 cases in the study group.Control group-fetal distress in the same period,slightly faster or decelerated fetal heart can return to normal,requiring cesarean section termination of pregnancy,namely emergency cesarean section group.Study group-Acute fetal distress fetal heart decelerate continuously for more than 3 minutes without recovery or placental abruption vaginal bleeding frequently,fetal heart change,namely optimized emergency cesarean section group.The DDI and DDI stages were compared between the two groups,and the prognosis of the two groups and the prognosis of the newborn were observed simultaneously.Results The DDI and DDI stages in the study group were lower than those in the control group(P<0.05).There was no significant difference in fetal prognosis between study group and control group(P>0.05).Conclusion In the case of acute fetal distress,placental abruption and other emergencies,shortening the time from emergency cesarean section to fetal delivery can effectively shorten the DDI time,thus reducing the rate of neonatal asphyxia and improving the prognosis of mother and child,which is worthy of further application and promotion in clinical practice.