人工破膜术对分娩结局及母婴的影响

刘振荣1，谢娟2

(1.徐州市铜山区中医院 妇产科，江苏 徐州 221116;2.南华大学附属第三医院妇产科，湖南 衡阳 421001)

摘要：目的探讨人工破膜和胎膜自然破裂对分娩结局以及母婴的影响。方法对正常分娩的初产妇100例临床资料进行回顾分析，将实施人工破膜的产妇50例设为治疗组；另50例胎膜自然破裂产妇设为对照组，比较2组产妇的分娩结局、羊水性状、经阴道分娩各产程时间、产后2 h出血量及分娩后并发症发生情况，并比较2组新生儿窒息、产瘤的发生率及并发症情况。结果治疗组产妇的剖宫产率明显低于对照组(P<0.05)；治疗组产妇阴道分娩率明显高于对照组(P<0.05)；治疗组新生儿窒息的发生率明显低于对照组(P<0.05)；治疗组产妇羊水污染的发生率明显低于对照组(P<0.05),而新生儿产瘤率高于对照组(P<0.05)；治疗组产妇分娩后并发症及新生儿并发症发生率明显低于对照组(P<0.05)。结论人工破膜分娩可加速产妇产程进展，提高自然分娩率,并可有效改善分娩结局。

关键词：胎膜自然破裂；人工破膜；分娩结局；新生儿窒息

DOI:10.13463/j.cnki.cczyy.2015.06.069

中图分类号：R271.9文献标志码：A

文章编号：2095-6258(2015)06-1285-03

基金项目：湖南省教育厅科技计划项目(13B098)。

作者简介：刘振荣(1971-)，女，大学本科，副主任医师，主要从事妇产科疾病研究。

收稿日期:(2015-08-31)

Artificial rupture of membrane on birth outcomes and the maternal and child health

LIU Zhenrong1, XIE Juan2

(1.Department of Obstetrics and Gynecology, Tongshan District Hospital of Traditional Chinese Medicine,

Xuzhou 221116, Jiangsu Province, China;

2.Department of Obstetrics and Gynecology, The Third Hospital Affiliated to University of South China,

Hengyang 421001, Hunan Province, China)

Abstract：ObjectiveTo explore the effect of artificial rupture of membrane and natural rupture of membrane on the birth outcomes and the maternal and child health. MethodsThe clinical materials of 100 primipara were retrospectively analyzed, among which 50 cases performed with artificial rupture of membrane were served as the observation group, while 50 cases with natural rupture of membrane were served as the control group. The birth outcomes, amniotic fluid character, each birth process time through vaginal delivery, amount of bleeding 2h after delivery, and complications in the two groups were compared. The occurrence rate of neonatal asphyxia and caput succedaneum, and the complications in the two groups were compared. ResultsThe cesarean section rate in the observation group was significantly lower than that in the control group (P<0.05). The vaginal deliver rate in the observation group was significantly higher than that in the control group (P<0.05). The amniotic fluid pollution rate in the observation group was significantly lower than that in the control group (P<0.05), while the neonatal caput succedaneum rate was significantly higher than that in the control group (P<0.05). The occurrence rates of postpartum complications and neonatal complications in the observation group were significantly higher than those in the control group (P<0.05). ConclusionThe artificial rupture of membrane can accelerate the birth process progress, enhance the natural delivery rate, and effectively improve the birth outcomes.

Keywords:natural rupture of membrane; artificial rupture of membrane; birth outcomes; neonatal asphyxia

胎膜自然破裂是正常分娩胎儿娩出前胎膜发生的自然破裂，是一种生理状态分娩下的胎膜破裂[1]。人工破膜是利用人工的方法刺破胎膜的手术操作，在产科常用，对产程进展起到明显的促进作用[2]。实施人工破膜还可在早期对产妇的羊水情况进行观察，了解产妇羊水胎粪污染的程度、胎儿宫内窘迫程度，使新生儿窒息率明显降低[3]。有研究[4]证实，人工破膜分娩对缩短产程及降低妊娠不良结局均十分有利。另有学者[5]认为，在分娩活跃早期行人工破膜不仅可使产程加速，还有利于降低新生儿窒息的发生率。……