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1.
目的:探讨卡孕栓联合催产素预防剖宫产产后出血的临床效果。方法:选择2014年1月至2014年6月在我院住院并经阴道分娩的产妇92例,随机分为观察组和对照组各46例。对照组在胎儿娩出后给予催产素治疗,观察组在胎儿娩出后给予卡孕栓联合催产素治疗,比较两组产妇产后2h、24h出血量、第三产程持续时间、不良反应发生情况。结果:观察组产妇产后2h、24h出血量均少于对照组,第三产程时间短于对照组,差异有统计学意义(P0.05);两组均无严重不良反应发生。结论:卡孕栓联合催产素预防剖宫产产后出血,能明显减少产后出血量,较好预防术后出血,且用药方便、安全、不良反应少。  相似文献   

2.
高霞  张毅  张冬霞 《海南医学院学报》2011,17(12):1694-1697
目的:探讨不同药物用于预防和治疗产后出血的临床疗效和安全性。方法:选取2006年6月~2011年6月因多胎妊娠、巨大胎儿、前置胎盘、胎盘早剥、羊水过多等有高危因素的产妇,计划剖宫产者1 380例随机分为3组,A组:胎儿娩出后宫体注入缩宫素20U,若有出血倾向者,加大缩宫素剂量,最大剂量80U;B组:胎儿娩出后宫体注入缩宫素20U,并于剖宫产术中胎盘娩出后擦拭宫腔后将米索前列醇片200μg置放宫腔底部,若有出血倾向者,给予嚼服或直肠给予米索前列醇片,最大剂量600μg;C组:胎儿娩出后宫体注入缩宫素20U+欣母沛250μg,若有出血倾向者,加大欣母沛剂量,最大剂量750μg,对3组资料进行回顾性分析。结果:预防性用药C组比A组、B组术后2h及术后24h出血量显著减少(P<0.01)。治疗性用药产后出血发生率明显低于A组、B组(P<0.05),治疗有效率明显高于A、B两组(P<0.05)。结论:欣母沛能很好预防高危产妇的产后出血发生率,治疗宫缩乏力性产后出血的效果明显,大大减少了切除子宫的危险,值得临床推广应用。  相似文献   

3.
 目的 观察卡贝缩宫素预防具有产后宫缩乏力高危因素产妇经阴道分娩产后出血的临床效果。方法 选择具有产后宫缩乏力高危因素的产妇200例,随机配对分为对照组和实验组,各100例。对照组在胎儿娩出后常规肌注缩宫素,实验组在胎儿娩出后静脉注射卡贝缩宫素。比较两组产后2 h内出血量、宫缩效果、生命体征及额外干预。结果 实验组产后2 h内出血量明显低于对照组,宫缩效果较对照组良好,需要的额外干预措施明显低于对照组,差异有统计学意义(P<0.05)。结论 对具有产后宫缩乏力高危因素的产妇,直接预防性给予卡贝缩宫素可有效加强宫缩,减少产后出血量。  相似文献   

4.
胡爱华   《中国医学工程》2011,(5):92-92,94
目的探讨第三产程干预对产后出血的影响。方法选择2009年10月至2010年10月在我院自然分娩产妇200例,均为初产妇,足月单胎,头位,采取阴道分娩,将以上产妇分为两组,观察组和对照组。对照组产妇胎儿娩出后不适用任何宫缩药物,待到胎盘剥离征象出现后协助产妇胎盘娩出或者让胎盘自行娩出。观察组产妇在胎儿肩娩出时,立即给予缩宫素20单位加入生理盐水注射液20mL中静脉推注,胎儿娩出后,适当按揉子宫底,直到胎盘娩出。胎儿娩出10min后如果胎盘没有娩出立即实施徒手剥离。记录两组产妇产后2h出血量,采用容积法和称重法计算产后出血量。记录两组产妇第三产程时间。结果两组第三产程时间比较,差异有统计学意义(P〈0.05);两组产后2h出血量比较,差异有统计学意义(P〈0.05)。结论对第三产程给予缩宫素干预,能够缩短第三产程,减少产后出血量,临床效果显著。  相似文献   

5.
目的 观察阴道分娩时卡孕栓不同时间置入阴道影响第三产程及预防产后出血的效果.方法 选择可能有产后出血高危因素经阴道分娩的产妇64例随机分成A、B两组,各组32例.两组产妇在胎儿娩出后立即肌内注射缩宫素10 U.在此基础上,A组产妇于胎儿娩出后至胎盘娩出前,用卡孕栓2粒(1 mg)置入阴道前壁;B组产妇在胎盘娩出后,用卡孕栓2粒(1 mg)置入阴道前壁.比较两组第三产程时间、胎盘娩出时出血量、产后2h出血量及产后出血的例数.结果 A组与B组比较,第三产程时间、胎盘娩出时出血量、产后2h出血量均有显著性差异(P<0.05).A组产后出血0例,B组产后出血2例.结论 卡孕栓置入阴道前壁用于阴道分娩预防产后出血效果良好,胎盘娩出前用药优于胎盘娩出后用药.  相似文献   

6.
目的:分析卡前列素氨丁三醇对于预防产妇宫缩乏力性产后出血的效果。方法:将110例腹壁横切口子宫下段剖宫产手术产妇采用随机数字表法分成对照组和观察组,每组各55例。观察组产妇在胎儿娩出后给予卡前列素氨丁三醇治疗,对照组产妇在胎儿娩出后给予缩宫素。结果:两组产妇产后2 h、产后24 h的出血量及两组产妇的第3产程时间比较,均无明显差异(P>0.05);观察组产妇的预防有效率为96.36%,对照组产妇为87.27%,组间差异具有统计学意义(P<0.05)。结论:卡前列素氨丁三醇对于预防产妇宫缩乏力性产后出血的疗效显著,可有效改善产妇的宫缩情况,有助于减少产妇产后出血量和降低其发生率。  相似文献   

7.
目的:探讨卡贝缩宫素对宫缩乏力性产后出血的预防效果。方法:选取2015年5月~2016年5月收治的256例单胎足月分娩产妇为研究对象,依据分娩方式分为阴道分娩、剖宫产组,各128例,按用药各组分为卡贝缩宫素组和缩宫素组,各64例;胎儿娩出后,卡贝缩宫素组给予卡贝缩宫素100μg入壶静滴,缩宫素组给予缩宫素10 U入壶静滴,同时缩宫素10 U入0.9%氯化钠500 m L静脉滴注至产后2 h;观察各组产时、产后2 h、产后24 h出血量,抽取分娩前及分娩后24 h肘静脉血5 m L,全自动血细胞分析仪测定各组24 h血红蛋白下降值,凝血检测仪检测产前、产后24 h凝血功能变化,观察各组用药前后血压、心率变化。结果:两种分娩方式中卡贝缩宫素组产时及产后2、24 h出血量少于缩宫素组,有统计学意义(P<0.05);两种分娩方式中卡贝缩宫素组分娩后24 h血红蛋白下降值小于缩宫素组,有统计学意义(P<0.05);产后各组24 h凝血功能指标无明显变化,差异无统计学意义(P>0.05);用药后各组心率、血压与用药前无明显变化,差异无统计学意义(P>0.05)。结论:卡贝缩宫素可有效预防宫缩乏力引起的产后出血,在阴道分娩、剖宫产均是安全有效的,值得临床推广。  相似文献   

8.
目的探讨阴道分娩时舌下含服卡孕栓配伍缩宫素预防产后出血的效果。方法选取在产科住院阴道分娩的产妇300例,随机分为两组,其中对照组150例,在胎儿娩出后给予静滴生理盐水500 ml加入缩宫素20 U,同时肌肉注射缩宫素10 U。另一组为观察组150例,在胎头娩出后给予舌下含服卡孕栓1 mg,胎儿娩出后静滴生理盐水500 ml加入缩宫素20 U。两组产妇的年龄、孕周、孕次等方面无差异(P0.05)。比较两组产妇第三产程的时间、产时产后出血量。结果观察组产妇第三产程的时间明显缩短,产时产后出血量明显下降,与对照组有统计学意义(P0.05),且观察组舌下含服卡孕栓后无严重的不良反应。结论卡孕栓配合缩宫素使用对预防阴道分娩的产后出血方便、安全,效果良好,值得产科推广。  相似文献   

9.
目的:探讨卡前列素氨丁三醇与缩宫素分别联合卡孕栓预防剖宫产产后出血的效果。方法将160例剖宫产产妇随机分为2组,均行横切口子宫下段剖宫产术,在胎儿娩出后卡前列素氨丁三醇组给予卡前列素氨丁三醇,缩宫素组给予缩宫素。对比分析2组产妇不良反应和产后出血情况。结果2组不良反应发生率对比差异无统计学意义(P>0.05);卡前列素氨丁三醇组剖宫产产妇分娩过程中、产后2 h 和产后24 h 出血量均明显少于缩宫素组(P<0.05)。结论卡前列素氨丁三醇联合卡孕栓用于剖宫产产后出血的预防效果较为理想。  相似文献   

10.
目的:探讨益母草注射液联合缩宫素预防剖宫产产后出血的临床疗效及安全性。方法:选取2015年6月—2016年6月我院收治的80例剖宫产产妇,随机分为观察组与对照组各40例,对照组胎儿娩出后仅常规给予宫缩素,观察组给予益母草注射液+缩宫素,观察两组产妇产后出血情况。结果:观察组产妇产后不同时间出血量明显低于对照组,P0.05,差异存在显著统计学意义;观察组产后不良反应发生率(5.0%)明显低于对照组(17.5%),P0.05,差异存在显著统计学意义。结论:益母草注射液联合缩宫素能够有效预防剖宫产产后出血的发生,减少产后出血量,而且安全性高,值得临床推广。  相似文献   

11.
目的:观察新斯的明在硬膜外麻醉下剖宫产妇胎儿娩出瞬间血压和心率的变化。方法:选择ASAⅠ~Ⅱ级拟行剖宫产手术的患者100例,随机分为对照组(n=50)和观察组(n=50)。所有病人均由L2~3行硬膜外麻醉,对照组经硬膜外腔注射1%利多卡因+0.5罗哌卡因混合液15mL加生理盐水1.5mL,观察组经硬膜外腔注射1%利多卡因+0.5罗哌卡因混合液15mL加新斯的明1.5mg(1.5mL),观察胎儿娩出瞬间产妇血压和心率的变化。结果:对照组血压明显下降,心率明显增快,观察组血压变化不明显,心率增快较少。结论:新斯的明对硬膜外麻醉下剖宫产妇胎儿娩出瞬间低血压有预防作用,且有利于心率的稳定。  相似文献   

12.
Trends in caesarean section in Western Australia, 1980-1987   总被引:1,自引:0,他引:1  
During the 1980s the incidence of both emergency and elective caesarean section in Western Australia increased, accompanied by a decrease in that of all other delivery methods. The proportion of emergency caesarean sections increased from 5.9%. of all deliveries in 1980 to 8.2% in 1987 and that of elective sections from 5.3% to 8.7%. For each year studied less than 50% of primiparous women delivering singletons had a normal vaginal delivery. Emergency caesarean sections were more common in primiparas and at the teaching hospital and elective sections in multiparas and at the metropolitan private hospitals. The proportion of primiparas having either emergency or elective caesarean sections rose with maternal age, but for multiparas the proportion having elective sections rose, but there were few differences in emergency sections with increasing age. Repeat caesarean sections, which made up 28.8% of the total in 1987, have contributed increasingly to the rising proportion of caesarean section deliveries. Unless the number of emergency sections in primiparous women falls and the challenge of vaginal birth after caesarean section is met, it is likely that the caesarean section rate in Western Australia will continue to increase over the next decade.  相似文献   

13.
高岩  蒋庆源  赵敏  周羽 《四川医学》2013,(9):1322-1324
目的 探讨倍他米松对预防择期剖宫产的双胎呼吸系统疾病的作用.方法 对2011年1月~2012年4月四川省妇幼保健院分娩孕周在34~38+6周择期剖宫产的双胎与单胎新生儿进行呼吸系统疾病发病率的回顾性分析.两组术前均预防性给予的倍他米松治疗.结果 共有86例双胎共172名双胎新生儿和189名单胎纳入研究,倍他米松治疗后择期剖宫产的双胎与单胎总的呼吸系统发病率无显著差异.结论 使用相同剂量和途径的倍他米松对预防择期剖宫产双胎新生儿呼吸系统疾病一样有效.  相似文献   

14.

Background:

Elective caesarean sections have been considered safer for both mother and the fetus compared to their emergency counterpart. However, emergency caesarean sections have continued to form bulk of caesarean deliveries in our facility.

Objective:

The objective of this study was to determine the caesarean section rate together with the trend, indications, and maternal mortality associated with elective caesarean operation.

Materials and Methods:

A retrospective analysis of clinical records of all the patients that had caesarean section between January 2002 and December 2010 (9 years) at Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria was conducted.

Results:

During the 9 year study period, 2284 caesarean sections were performed out of 22,985 total deliveries at UDUTH Sokoto, thus giving a caesarean section rate of 9.9%. Emergency and elective operations accounted for 1784 (78.2%) and 498 (21.8%) of the cases respectively. The rate of elective caesarean section increased from 1.7% in 2002 to 3.2% in 2007. Thereafter it declined gradually to 1.8% in 2010. Repeat caesarean section (30.7%) and malpresentation (17.1%) were the most common indications for elective caesarean operation. There were 18 maternal deaths from caesarean section and only one from the elective caesarean procedure.

Conclusion:

The rising trend in the elective caesarean section rate in this study underscores the need for better and improved patient selection together with counseling on its benefits and risks. This is because despite the fact that it is safer than emergency caesarean operation, it is not entirely devoid of complications. Routine use of spinal anesthesia in performing the procedure should be encouraged.  相似文献   

15.
We studied 510 patients in a retrospective, nonrandomized, comparative survey of vaginal births and repeat caesarean section after one primary caesarean section at the Port Moresby General Hospital. 478 (94%) were allowed a trial of scar (TOS). The most common indications for elective caesarean section in the other 32 patients were cephalopelvic disproportion (CPD) 31%, contracted pelvis 19% and preeclampsia 12.5%. In 41% of patients TOS was terminated by emergency caesarean section. Logistic regression analysis showed that the following were significantly associated with repeat caesarean section after TOS: parity of one, no vaginal birth after the primary caesarean section, narrow obstetric conjugate, birthweight of 2500 g or greater, short stature, high level of the head at admission to the labour ward and region of origin.  相似文献   

16.
A total of 2176 consecutive patients who had had one previous caesarean section were studied retrospectively. A repeat elective caesarean section was performed in 395 (18.2%). Labour started spontaneously in 1363 patients, 301 of whom were given oxytocin to accelerate inert labour, and was induced by amniotomy and infusion of oxytocin in 418 women; 1618 of these 1781 patients (90.8%) delivered vaginally. Patients who had had a previous vaginal delivery were more likely to deliver vaginally again. Those women in whom the initial caesarean section had been performed during labour before the cervix was 4 cm dilated were less likely to deliver vaginally than those who had progressed further in labour or those who had had an elective caesarean section. Similarly, those who received oxytocin to stimulate inert labour were more likely to require a repeat caesarean section than those who did not. The uterine scar ruptured in only eight (0.45%) of the 1781 patients allowed into labour. The risk of rupture of the scar was not increased by the use of oxytocin alone either to induce or to accelerate labour. The combination of oxytocin to accelerate labour and epidural analgesia to provide pain relief, however, was associated with an increased incidence of scar rupture. Labour may be safely allowed in women who have had a previous caesarean section, most of whom will deliver vaginally. Induction of labour does not increase the risk of either a repeat caesarean section or rupture of a uterine scar.  相似文献   

17.
What constitutes proper management for the singleton baby who presents by the breech at term has remained one of the most contentious subjects in obstetric practice. Perinatal morbidity and mortality are much higher in breech than in cephalic presentation. Elective caesarean section has been increasingly used in an attempt to improve the perinatal outcome. But caesarean section has immediate and late maternal complications. Some of these complications can be catastrophic. External cephalic version (ECV) at term, under tocolysis if necessary, will reduce the incidence of vaginal breech delivery and the incidence of caesarean section. Where ECV fails, the use of a selective management protocol will allow trial of breech labour in suitable cases, thus further reducing the incidence of elective section. Symphysiotomy may save the life of the baby whose head is trapped by disproportion.  相似文献   

18.
陈坚  张玉琴 《现代医学》2014,(4):404-407
目的:观察宫腔纱条填塞用于治疗剖宫产术中大出血的疗效。方法:回顾性分析新疆伊宁市人民医院产科2011年1月至2012年12月剖宫产术中采用宫腔纱条填塞治疗43例大出血患者的临床资料,并与2007~2008年和2009~2010年两个同时期的相关数据进行比较和统计学分析。结果:43例治疗效果满意,无一例切除子宫,无产褥期出血和感染,无产妇死亡病例,产后42 d随访子宫复旧良好。结论:宫腔纱条填塞压迫止血法治疗剖宫产术中大出血操作直接、简便,止血快速、有效,既减少患者出血及因出血过多而造成的全身伤害,又尽最大可能保留了生殖器官。术中纱条有序填塞、不留死腔,术后及时应用宫缩剂同时联合应用抗生素可取得良好效果。  相似文献   

19.
目的:检测雌、孕激素受体在自然临产经阴道分娩以及选择性剖宫产产妇的胎盘组织中的表达,探讨雌、孕激素受体(ER,PR)的表达对分娩发动的影响及其机制。方法:运用免疫组化法检测22例自然临产经阴道分娩的产妇胎盘和胎膜中ER、PR的表达情况,以18例选择性剖宫产为对照,并结合临床资料对实验数据进行统计学分析。结果:①实验组和对照组PR阳性率分别为73.79±13.09%、74.02±14.40%,两组对照,无统计学差异(P>0.05)。②自然临产组和选择性剖宫产组胎盘组织中的ER阳性表达率分别为86.11±14.90%和82.65±14.30%,两组相比无显著性差异(P>0.05)。结论:人类妊娠末至分娩发动前,ER、PR在妊娠组织中的表达水平均无显著下降。功能性孕激素撤退可能就是分娩发动的启动因素。  相似文献   

20.
OBJECTIVE: To estimate the risks of maternal and perinatal morbidity and mortality in a second pregnancy, attributable to caesarean section in a first pregnancy. DESIGN AND SETTING: Cross-sectional analytic study of hospital births in New South Wales, based on linked population databases. PARTICIPANTS: 136 101 women with one previous birth who gave birth to a singleton infant in NSW in 1998-2002. MAIN OUTCOME MEASURES: Crude and adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for maternal and perinatal morbidity and mortality. RESULTS: 19% of mothers had a caesarean section in their first pregnancy. Compared with mothers who had had primary vaginal births, mothers who had had primary caesarean section and underwent labour in the second birth were at increased risk of uterine rupture (aOR, 12.3; 95% CI, 5.0-30.1; P < 0.0001), hysterectomy (3.5; 1.5-8.4; P < 0.01), postpartum haemorrhage (PPH) following vaginal delivery (1.6; 1.4-1.7; P < 0.0001), manual removal of placenta (1.3; 1.1-1.6; P < 0.01), infection (6.2; 4.7-8.2; P < 0.0001) and intensive care unit (ICU) admission (3.1; 2.1-4.7; P < 0.0001); among mothers who did not undergo labour (ie, had an elective caesarean section), there was a lower risk of PPH (0.6; 0.5-0.7; P < 0.0001) and ICU admission (0.4; 0.3-0.5; P < 0.0001). For infants there was increased risk of preterm delivery (1.2; 1.1-1.3; P < 0.0001) and neonatal intensive care unit admission following labour (1.6; 1.4-1.9; P < 0.0001) in the birth after primary caesarean section. The occurrence of stillbirth was not modified by labour. CONCLUSIONS: Caesarean section in a first pregnancy confers additional risks on the second pregnancy, primarily associated with labour. These should be considered at the time caesarean section in the first pregnancy is being considered, particularly for elective caesarean section for non-medical reasons.  相似文献   

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