剖宫产术中不同脐带结扎时间对足月母婴结局的影响

Effects of three different umbilical cord ligation times on the outcome of full-term mothers and infants during cesarean section

目的探讨剖宫产术中不同脐带结扎时间对足月母婴结局的影响。方法回顾性分析108例行剖宫产术的产妇的临床资料,以不同脐带结扎时间分为A组(分娩后10 s内)与B组(分娩后10~60 s)和C组(分娩后60~240 s)和D组(分娩240 s后结扎脐带),各27例。对比4组Apgar评分以及产后24 h出血量,对比4组产后血红蛋白、红细胞比容水平和足月母婴结局。结果4组Apgar评分、新生儿光疗率、产妇产后出血过多占比、胎儿死亡率进行比较,差异无统计学意义(P>0.05)。与A、B、D组的产后出血量进行比较,C组较低,差异有统计学意义(P<0.05)。4组产后48 h的血红蛋白、红细胞比容水平均比产前降低,产后48 h 4组间血红蛋白、红细胞比容比较,差异有统计学意义(P<0.05)。结论剖宫产术中进行延迟结扎脐带60~240 s秒安全可靠,可降低出血量,不增加对足月母婴结局的影响。

Objective To explore the effect of different time of umbilical cord ligation during cesarean section on the outcome of full-term mothers and infants.Methods The clinical data of 108 women who underwent cesarean section were retrospectively selected and divided into group A(within 10 s after delivery),group B(10〜60 s after delivery),group C(60〜240 s after delivery)and group D(240 s after delivery)according to different umbilical cord ligation time,27 cases in each group.The Apgar score,24 h postpartum blood loss,postpartum hemoglobin,erythrocyte volume and full-term maternal and infant outcomes were compared among the 4 groups.Results There were no significant differences in Apgar score,neonatal phototherapy rate,the proportion of postpartum hemorrhage and fetal mortality among the four groups(P>0.05).Compared with groups A,B and D,the postpartum blood loss in group C was lower,and the difference was statistically significant(P<0.05).The levels of hemoglobin and erythrocyte specific volume in the 4 groups at 48 h after operation were lower than those before operation,and the differences among the 4 groups at 48 h after operation were statistically significant(P<0.05).Conclusion Delayed ligation of umbilical cord for 60~240 seconds during cesarean section is safe and reliable,which can reduce the bleeding volume,and do not increase the impact on the outcome of full-term mothers and infants.