第二产程时限改变对母儿预后的影响

目的：探讨第二产程时限改变对产妇和新生儿预后的影响。方法回顾性分析2012年1月至2015年5月在该院妇产科住院分娩的单活胎、头位、初产、未使用分娩镇痛、第二产程超过2 h的产妇，共计201例。根据不同的第二产程时限分为观察组和对照组，设定以3 h为第二产程时限的为观察组，共163例；而以2 h为第二产程时限的则为对照组，共38例。结果两组产妇产后出血、产后发热、尿潴留等不良妊娠结局的发生率，以及新生儿窒息、需转儿科的发生率差异无统计学意义（P＞0．05）；观察组产妇软产道裂伤72例，无伤口愈合不良，对照组产妇伤口愈合不良3例，差异有统计学意义（ P＜0．05）。结论以3h为第二产程时限可降低剖宫产率，不增加严重不良母儿结局。

The effects of a changed second stage of labor duration on the maternal and neonatal outcomes

Objective To investigate the influence of the different second stage of labor duration on the maternal and neo‐natal outcomes .Methods Data were retrospectively analyzed from 201 nulliparous women delivering a singleton infant in cephalic presentation without labor analgesia hospitalized in our hospital between January 2012 and May 2015 ,whose second stage pro‐gressed beyond 2 hours .They were divided into observation group and control group according to different second stage of labor du‐ration ,and cases with a second stage of labor duration of three hours were in the observation group (163 cases) ,and those within two hours were in the control group (38 cases) .Results Whether the limit of the second stage of labor duration of 2 hours ,or 3 hours ,the risk of postpartum hemorrhage ,postpartum fever ,urinary retention and neonatal asphyxia ,admission to the neonatology department in two groups were not significantly different(P>0 .05) .However ,there was significance difference in the rate of soft birth canal laceration(72 cases in the observation group) ,poor wound healing (0 case in the observation group and 3 cases in the control group ,P<0 .05) .Conclusion a second stage of labor duration of 3 hours could reduce the rate of cesarean section ,and with no increase in severe adverse maternal and neonatal outcomes .