第二产程可疑型胎心监护与母儿近期结局的研究

Study onshort-term outcomes of pregnant women and category Ⅱ electronic fetal monitoring tracing in second stage of labor

摘要:

目的 研究第二产程可疑型胎心监护（胎监）与母儿近期结局的关系。方法 选取2017 年1 月1 日- 2017 年6 月30 日在广州市妇女儿童医疗中心定期产检、足月单胎头位分娩、产程中有连续电子胎心监护 的527 例孕妇为研究对象，其中第二产程出现可疑型胎监的225 例孕妇为病例组，第二产程为正常型胎监的 302 例孕妇为对照组，比较两组孕妇及新生儿近期结局。结果 病例组孕妇的会阴侧切率为71.1%、钳产率为 29.3%、羊水异常率为38.2%、新生儿窒息率为2.2%、新生儿住院率为10.2%，均高于对照组（均P <0.05）； 而两组间产后出血量及新生儿脐动脉pH<7.20 的比较则差异无统计学意义（P >0.05）。结论 第二产程可疑 型胎监会增加母儿近期不良结局的发生率。

Abstract:

Objective To investigate the correlation between CategoryⅡ electronic fetal monitoring (EFM) tracing happened in the second stage of labor and the incidence of adverse short-term pregnancy outcomes. Methods A total of 527 subjects who had prenatal examination in Guangzhou Women and Children’s Medical Centre from 1st January 2017 to 30th June 2017 were included. The subjects were singleton term deliveries with cephalic presentation. Intrapartum EFM were conducted continuously for the subjects. Totally 225 women with Category Ⅱ EFM tracing in the second stage of labor were classified as case group and the rest with normal EFM tracing in the second stage of labor were classified as control group. Incidence rate of short-term pregnancy outcomes was compared between the two groups. Results Pregnant women in the case group had higher rate of episiotomy (71.1%, P = 0.000), forceps delivery (29.3%, P = 0.000), amniotic fluid contamination (38.2%, P = 0.000), asphyxia of neonates (2.2%, P = 0.023) and admission of neonates (10.2%, P = 0.000) comparing with those in the control group. No statistically significant differences of postpartum hemorrhage and arterial cord (pH < 7.20) were found between the two groups. Conclusion Adverse pregnancy outcomes are more likely to happen in the women with category Ⅱ EFM tracing in the second stage of labor.