催产素引产时间对足月妊娠期高血压和轻度子痫前期孕妇妊娠结局的影响

The influence of cumulative time of oxytocin inducing labor on pregnancy outcome in pregnant women with term gestational hypertension and mild preeclampsia

目的:探讨催产素引产时间对足月妊娠期高血压和轻度子痫前期孕妇围产儿及妊娠结局的影响。方法:回顾性分析2020年1月~2022年3月在深圳市宝安区妇幼保健院分娩的319例足月妊娠期高血压和轻度子痫前期孕妇。根据累积静脉滴注催产素时间不同,将累计滴催时间<9 h者为A组(86例),≥9 h者为B组(75例),从未使用催产素为对照组(158例)。比较三组围产儿不良结局和妊娠不良结局,包括羊水污染、胎儿窘迫、新生儿窒息、重度子痫前期、胎盘早剥、产后出血发生率、分娩方式及阴道分娩患者的产程。结果:B组剖宫产率明显高于A组、对照组,差异有统计学意义(P<0.05),B组总产程时间明显较A组延长,差异有统计学意义(P<0.05)。三组羊水污染、胎儿窘迫、新生儿窒息的发生率比较,差异无统计学意义(P>0.05),三组重度子痫前期、胎盘早剥、产后出血的发生率比较,差异无统计学意义(P>0.05)。结论:足月妊娠期高血压和轻度子痫前期孕妇催产素引产时间累计到达9 h以后,阴道分娩产程延长,剖宫产率明显升高,但并不会增加胎儿窘迫、新生儿窒息、重度子痫前期、胎盘早剥、产后出血的发生率,对临床治疗有指导意义。

Objective To investigate the influence of cumulative time of labor induced by oxytocin on perinatal and pregnancy outcome in pregnant women with term gestational hypertension and mild preeclampsia.Method A retrospective analysis of 319 term pregnant women with gestational hypertension and mild preeclampsia who were hospitalized in the Shenzhen Baoan Women′s and Children′s Hospital from January 2020 to March 2022.Depending on the different cumulative intravenous infusion time of oxytocin,the pregnant women were divided into group A(h<9 hours,n=86),group B(h≥9 hours,n=75),and control group(never used oxytocin,n=158).The adverse perinatal outcomes and pregnancy outcomes of the three groups were compared,including incidence of amniotic fluid contamination,fetal distress,neonatal asphyxia,severe preeclampsia,placental abruption,and postpartum hemorrhage,mode of delivery,and duration of vaginal delivery.Results The incidence of cesarean section in group B was significantly higher than that in group A and control group(P<0.05),the total labor time in group B was significantly longer than that in group A(P<0.05).The incidences of amniotic fluid pollution,fetal distress and neonatal asphyxia were not statistically significant among the three groups(P>0.05),and the incidences of severe preeclampsia,placental abruption,and postpartum hemorrhage were not statistically significant between the three groups(P>0.05).Conclusion The cumulative time of oxytocin induction of labor in pregnant women with term gestational hypertension and mild preeclampsia exceeds 9 hours,which will increase the probability of prolonged vaginal delivery and the incidence of cesarean section,but not increase the incidence of amniotic fluid contamination,fetal distress,neonatal asphyxia,severe preeclampsia,placental abruption,and postpartum hemorrhage.It has guiding significance for clinical treatment.