头位脐带绕颈不同分娩方式与新生儿窒息的关系

目的探讨不同分娩方式对头位脐带绕颈的处理对新生儿窒息的影响。方法选择我院2009年9月至2011年9月单胎头位脐带绕颈足月妊娠产妇共280例,上述病例均无产科合并症、相关并发症。根据分娩方式不同分为阴道分娩组和剖宫产组。阴道分娩组均在局麻下行左侧会阴侧切分娩。剖宫产组均在持续硬膜外麻醉下实施剖宫产术。其中阴道分娩组160例;剖宫产组120例。观察脐带绕颈不同分娩方式对新生儿窒息及胎儿宫内窘迫发生的影响。结果阴道分娩组胎儿宫内窘迫发生率显著高于剖宫产组,差异有统计学意义(P<0.05);阴道分娩组新生儿窒息发生率与剖宫产组比较,差异无统计学意义(P>0.05)。结论根据脐带绕颈情况选择合适的分娩方式,脐带绕颈1周妊娠病例可建议实施自然分娩,脐带绕颈>2周的可建议实施剖宫产进行分娩。

Different Delivery Modes of Nuchal Cord Cephalic Presentation and Asphyxia Neonatorum

Objective To discuss the effect of different delivery modes for pregnancy with nuchal cord cephalic presentation on neonatal asphyxia.Methods 280 term pregnancy women(all without obstetric complications)with nuchal cord cephalic presentation from Sep.2009 to Sep.2011 were divided into vaginal delivery group and cesarean section group according to their delivery mode.Vaginal delivery group(n=160)was performed left lateral episiotomy under local anesthesia,while cesarean section group(n=120)was performed under continuous epidural anesthesia.Effect of different modes of delivery on neonatal asphyxia and intrauterine fetal distress was observed.Results The incidence of fetal distress in vaginal delivery group was obviously higher than that in cesarean section group,the difference had statistical significance(P<0.05).The difference of the incidence of neonatal asphyxia between the two groups had no statistical significance(P>0.05).Conclusion The delivery mode can be chosen according to nuchal cord situations.Natural delivery can be chosen in case of 1 circle of nuchal cord,while cesarean section is suggested for the situation of >2 circles.