713例胎儿窘迫行剖宫产临床分析

Cesarean Section in 713 Fetal Distress Patients

目的探讨因胎儿宫内窘迫丽行剖宫产的指征。 方法胎儿宫内窘迫行剖宫产的孕妇713例,按单纯胎儿电子监护异常、单纯羊水异常、胎儿电子监护异常合并羊水异常分为3组,并与术中所见胎儿宫内窘迫相关因素及新生儿Apgar评分对照。 结果Ⅰ组新生儿Apgar评分≤7分发生率为5.05％,Ⅱ组新生儿Apgar评分≤7分发生率为2.32％,Ⅲ组新生儿Apgar评分≤7分发生率为9.80％,从结果看Ⅲ组与Ⅰ组、Ⅱ组相比有显著性差异(P<0.05)。 结论胎心异常与羊水污染同时存在,胎儿存在或潜在缺氧情况,新生儿窒息率高,应及时娩出胎儿。单纯胎心异常或羊水污染应根据情况,有无伴随高危因素,在严密监护和积极处理下决定分娩方式。

Objective To investigate the indication of cesarean section in fetal distress. Methods Cesarean section performed in 713 patients with fetal distress was analyzed. According to fetal heart monitoring, or stained amniotic fluid abnormalities or both of them 713 patients were devided in three groups. Results The low Apgar score (≤7) rate of newborns was 5. 05% ,2. 32% and 9. 80% in Group Ⅰ, Group Ⅱ, Group Ⅲ, respectively. The differences between group Ⅲ and two other groups were significant. Conclusion Under close observation and monitoring, pregnancy and trial labor might continue in patients with abnormal fetal heart rate or stained amniotic fluid except in patients complicated with high risk factors.