硬膜外分娩镇痛后胎心异常对分娩方式和新生儿的影响

目的：观察分娩镇痛后胎心异常对分娩方式和新生儿的影响。方法回顾性分析829例硬膜外分娩镇痛病例的临床资料，对比分娩镇痛后出现胎心异常组（A组）和未出现胎心异常组（N组）产妇的剖宫产率和剖宫产原因，以及新生儿出生后1 min和5 min Apgar评分。结果 A组剖宫产率明显高于N组（P＜0．05）。剖宫产原因：胎方位异常两组差别无统计学意义（P＞0．05），胎儿窘迫A组明显高于N组（P＜0．05），活跃期停滞A组明显低于N组（P＜0．05），继发性宫缩乏力A组明显低于N组（P＜0．05）。两组新生儿出生后1 min和5 min Apgar评分差别无统计学意义（P＞0．05）。结论分娩镇痛后出现胎心异常的产妇产程中因胎儿窘迫而改行剖宫产的比例明显增高，但对新生儿无不良影响。

The effect of fetal heart rate abnormalities during labour analgesia on the obstetric outcome and neonatal health

Objective To evaluate the effect of fetal heart rate(FHR)abnormalities in labouring patients with epidural analgesia on the outcome of the delivery and neonatal health .Methods The data of 829 cases of continuous epidural analgesia for labour anal‐gesia were retrospectively analyzed .All cases were divided into two groups :FHR abnormalities (group A ) and FHR normalities (group N) .The rate of cesarean section ,the reason of cesarean section and 1minute、5minute Apgar scores of neonates were recor‐ded .Results The incidence of cesarean section was significantly higher in group A than in group N .The reason of cesarean section :Compared with group N ,the rate of Abnormal fetal position was no significant difference (P>0 .05);fetal distress was higher in group A(P<0 .05);protracted active phase was lower in group A (P<0 .05);inefficient uterine action was lower in group A (P<0 . 05) .Apgar scores of neonates were no significant difference between two groups .Conclusion There are correlation between FHR abnormalities and fetal distress during labour Analgesia with epidural analgesia .However ,Neonatal outcome was not influenced .