长期的第二阶段的劳动在primiparas和围产期的结果
Shira Fridman Lev1, Yair Gottlieb1, Amy Solnica2
1Department of Obstetrics & Gynecology, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel.
概括
长时间的第二阶段的劳动在primiparous分娩显著增加对不利的母亲和新生儿的结果的风险. 这包括剖腹产和新生儿重症监护室入院率较高.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 新生儿结局的结果.
背景情况:
- 劳动的第二阶段是分娩的关键时期.
- 定义和理解长期劳动对于优化孕产妇和新生儿护理至关重要.
- 孕期妇女在分娩过程中可能会面临独特的挑战.
研究的目的:
- 为了评估在初孕期分娩的分娩方式.
- 评估与延长的分娩第二阶段相关的孕产妇和新生儿不良结果.
- 为了比较带有和没有外周止痛的结果.
主要方法:
- 对55309名初代孕产妇 (2005-2022) 的回顾性队列研究.
- 劳动的长期第二阶段定义为>3小时带外周支架或>2小时没有.
- 通过使用统计分析,比较劳动阶段的长期和正常第二阶段的结果.
主要成果:
- 延长的第二阶段发生在13.1%的初级患者中,其中85%接受了外周注射.
- 在长期治疗组中,剖腹产的发生率明显高 (8.5%对0.8%).
- 观察到产后出血的风险增加,严重的围破伤,肩膀缩,NICU入院>72h,关节骨骨折和低Apgar分数.
结论:
- 经历了长时间的第二阶段分娩的Primiparas面临着对母亲和新生儿不良结果的高风险.
- 这些发现强调了警监测和及时干预的重要性.
- 延长第二阶段的持续时间可能会加剧负面结果.
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