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目的研究活跃期胎心音正常羊水Ⅱ~Ⅲ度粪染者剖宫产与阴道分娩的母婴结局。方法将2015年5月至2016年5月活跃期胎心音正常羊水Ⅱ~Ⅲ度粪染患者68例分为对照组(34例)与实验组(34例)。其中对照组产妇行阴道分娩,实验组产妇采取剖宫产终止妊娠。对比产后两组并发症情况及两组新生儿Apgar评分。结果实验组产后并发症发生率为29.4%,较对照组的8.8%高,组间比较差异有统计学意义(P<0.05)。相比于对照组新生儿,实验组新生儿出生后1、5、10 min时的Apgar评分更高,但组间比较差异未见统计学意义(P>0.05)。结论羊水Ⅱ~Ⅲ度粪染但胎心音无异常的情况下,经阴道分娩不会影响产后母婴结局,临床应对羊水粪染患者产程进展、阴道分娩条件和胎粪污染程度实施充分评估,并根据胎心监护结果确定分娩方式,以改善围生儿结局,降低新生儿窒息率。
Objective To study the maternal and infant outcome of cesarean section and vaginal delivery in active amniotic fluid with active fetal heart sound. Methods From May 2015 to May 2016, 68 patients with stage Ⅱ ~ Ⅲ feces stained with amniotic fluid of normal fetal heart rate were divided into control group (34 cases) and experimental group (34 cases). The control group maternal vaginal delivery, the experimental group maternal take cesarean termination of pregnancy. Comparisons of postpartum complications and neonatal Apgar scores of two groups. Results The incidence of postpartum complications in the experimental group was 29.4%, which was 8.8% higher than that in the control group. The difference between the two groups was statistically significant (P <0.05). Compared with the control group, the Apgar score was higher at 1, 5 and 10 min after birth in experimental group than that in control group, but no significant difference was found between the two groups (P> 0.05). Conclusion Amniotic fluid Ⅱ ~ Ⅲ fecal staining, but fetal heart sound without abnormal circumstances, vaginal delivery will not affect postpartum mothers and babies outcomes, clinical response to amniotic fluid meconium in patients with labor progress, vaginal delivery conditions and meconium contamination fully implemented, And according to the results of fetal heart rate to determine the mode of delivery to improve perinatal outcome and reduce neonatal asphyxia.