【摘要】 目的:探讨新第二产程各时间段内母婴近期并发症的发生率和差异性。方法:选择单胎头位,孕足月,排除产科并发症、合并症,根据新第二产程时间标准,在确保母婴安全的情况下,给予孕妇充分的试产时间,不提前干预。初产妇根据第二产程时间不同分成1 h组、2 h组和3 h组,经产妇分成1 h组和2 h组。分别统计分析各组之间的新生儿窒息率、产后出血率、Ⅱ°及以上会阴裂伤率、产后尿潴留率、吸引产率及会阴侧切率等指标有无差异。结果:初产妇各组新生儿窒息率比较,初产妇1 h组与3 h组Fisher确切概率法比较差异有统计学意义(P<0.05);初产妇产后出血率比较,各组采用Fisher确切概率法比较差异均无统计学意义(P>0.05);初产妇产后尿潴留率比较,初产1 h组与3 h组采用Fisher确切概率法比较差异有统计学意义(P<0.05),初产2 h组与3 h组采用Fisher确切概率法比较差异有统计学意义(P<0.05)。经产妇各组产后尿潴留率各组采用Fisher确切概率法比较差异有统计学意义(P<0.05)。初产妇吸引产率比较,初产3 h组与1 h组采用Fisher确切概率法比较差异有统计学意义(P<0.05),初产3 h组与2 h组采用Fisher确切概率法比较差异有统计学意义(P<0.05);初产妇会阴侧切率比较,初产1 h组与2 h组及3 h组采用Fisher确切概率法比较差异均有统计学意义(P<0.05)。经产妇各组Ⅱ°及以上会阴裂伤率采用Fisher确切概率法比较差异有统计学意义(P<0.05),经产妇吸引产率采用Fisher确切概率法比较差异有统计学意义(P<0.05),经产妇会阴侧切率采用Fisher确切概率法比较差异有统计学意义(P<0.05)。结论:延长1 h的第二产程时限,初产妇和经产妇的产后出血率及Ⅱ°及以上会阴裂伤率及经产妇新生儿窒息率并没有增加,但初产妇新生儿窒息率、初产妇和经产妇的产后尿潴留率、吸引产率、会阴侧切率有增加。更多还原

【Abstract】 Objective: To discuss the incidence rate and difference of the recent maternal and neonatal complications of each period in the new second stage of labor duration. Methods: The selection criteria were singleton and cephalic position and full term without obstetric complications. In the case of ensuring the safety of the mother and the baby and according to the new second stage of labor duration,pregnant women were given abundant delivery time without early intervention. The primiparas were divided into 1 h group,2 h group and 3 h group,according to different stages in the second stage of labor duration. The pluriparas were divided into 1 h group and 2 h group. The incidence rate of neonatal asphyxia,postpartum hemorrhage,laceration of birth canal( above II degree),postpartum urinary retention,vacuum extraction and episiotomy were observed in different groups. Whether there were statistical differences between all groups was analyzed.Results: The difference of the rate of neonatal asphyxia between the 1 h group and the 3 h group in primiparas was statistically significant( P < 0. 05),using the Fisher exact probability method.Compared with the rate of postpartum hemorrhage in primiparas,there was no significant difference between all groups( P > 0. 05),using the Fisher exact probability method. The difference of the rate of postpartum urinary retention between the 1 h group and the 3 h group in primiparas was statistically significant( P < 0. 05),with the Fisher exact probability method. The difference of the rate of postpartum urinary retention between the 2 h group and the 3 h group in primiparas was statistically significant( P < 0. 05),using the Fisher exact probability method. The difference of postpartum urinary retention rate between each group in pluriparas was statistically significant( P < 0. 05),using the Fisher exact probability method. The difference of the rate of vacuum extraction between the 3 h group and the 1 h group in primiparas was statistically significant( P < 0. 05),using the Fisher exact probability method. The difference of the rate of vacuum extraction between the 3 h group and the 2 h group in primiparas was statistically significant( P < 0. 05),using the Fisher exact probability method. The difference of the rate of episiotomy between the 1 h group,the 2 h group and the 3 h group in primiparas was statistically significant( P < 0. 05),with the Fisher exact probability method. The difference of laceration of birth canal rate( above II degree) between each group in pluriparas was statistically significant( P < 0. 05),using the Fisher exact probability method. The difference of vacuum extraction rate between each group in pluriparas was statistically significant( P < 0. 05),using the Fisher exact probability method. The difference of episiotomy rate between each group in pluriparas was statistically significant( P< 0. 05),using the Fisher exact probability method. Conclusion: With one hour in the new second stage of labor duration extending,the rate of postpartum hemorrhage,laceration of birth canal( above II degree) and neonatal asphyxia in primiparas and pluriparas will not increase significantly,but the rate of neonatal asphyxia in primiparas increases,while the rate of postpartum urinary retention,vacuum extraction and episiotomy in primiparas and pluriparas increases significantly.更多还原