无医学指征剖宫产新生儿窒息原因分析

An Analysis to Causes of Newborn Asphyxia in Cesarean Section without Medical Indication

目的 :比较无医学指征剖宫产与阴道顺产对新生儿窒息发生的影响及分析无指征剖宫产新生儿窒息的原因。方法 :将 2 5 8例无医学指征坚决要求剖宫产的孕妇作为剖宫产组。选择同期阴道顺产 2 5 0例为对照组 ,比较两组新生儿出生时的窒息情况及统计无指征剖宫产新生儿窒息的原因。结果 :剖宫产组的新生儿窒息率显著高于阴道顺产组 (P <0 .0 1) ,导致剖宫产新生儿窒息的主要原因有 :出生后未及时建立自主呼吸 ;胎头高浮 ,取头困难 ;仰卧位低血压综合征等。结论 :剖宫产并不是降低新生儿窒息的可靠方法 ,必须加强对孕产妇有关分娩方式的宣教 ,正确掌握剖宫产的指征。

Objective: To compare the etiological influence on newborn asphyxia of cesarean section without medical indication to that of vaginal delivery. Methods: Pregnant women of 258 cases who insisted on cesarean section though had not medical indication were taken as cesarean section group, and other 250 cases with vaginal delivery at the same period were taken as control group. The newborn asphyxia condition of two groups to be compared, and to get the result of statics of the causes in newborn by cesarean section without medical indication. Results: The asphyxia rate of cesarean section group was much higher than the control group(P<0.01).The main causes of newborn asphyxia consist of no autonomic breath established in time after birth and fetal head with high position to result in difficulty for to be taken out, and supine position hypotension syndrome and so on. Conclusion: Cesarean section is not a reliable method to reduce asphyxia of newborn, so that medical staff should take more education about delivery mode to pregnant women and control the cesarean section indications appropriately.