电邮这篇文章 手术阴道分娩：母亲和新生儿的结局
- 作者: Leonova M.1, Aganezova N.2, Aganezov S.2, Frederiks E.1, Dymarskaya Y.2
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隶属关系:
- Maternity Hospital No. 13
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 69, 编号 2 (2020)
- 页面: 33-42
- 栏目: Original Research
- URL: https://journals.rcsi.science/jowd/article/view/21372
- DOI: https://doi.org/10.17816/JOWD69233-42
- ID: 21372
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详细
绪论俄罗斯和世界上一样，腹部分娩手术的频率持续增长。2017年，俄罗斯联邦的这一比例达到29.3%。在分娩的第二阶段，腹式分娩的另一种选择是手术阴道分娩。
目的是分析不同类型的手术阴道分娩产妇和新生儿的分娩结果。
材料与方法。我们研究了2015-2018年期间293例分娩病例。分为三组:主要组(I)- 172名妇女，
采用产科钳手术分娩;对照组(II)85例，胎头位置于骨盆出口平面的真空抽提术分娩;对照组(III) -
不使用器械接生的阴道分娩34例，I组114例采用产钳输出(Ia亚组)，60例采用腔式产钳(IB亚组)。
研究成果组发生阴道黏膜破裂发生率为21.3%，对照组发生率为10.6%，对照组发生率为2.9%，
p < 0.05。对照组阴道血肿1例(2.9%)，主组阴道血肿3例(1.7%，p > 0.05)。无一例肛门括约肌
损伤。与Ia组(473 ± 20.7毫升)、II组(418 ± 24.86毫升)和III组(347 ± 33、43毫升)相比，IB组
(554 ± 44.87毫升，p < 0.05)失血量最大。产钳排产组和真空抽胎组出血量差异无统计学意义(p > 0.05)。大多数儿童出生时身体状况良好(84.5名;77.6;I、II、III组分别占88.2%)。新生儿头颅血肿发生在胎儿真空抽提后(32.9%)，高于使用产钳后(9.2%，p < 0.01)和对照组(5.9%，p < 0.01)。
新生儿视网膜出血则没有。儿童转到儿童医院的频率无显著差异(7.5;9.4;I、II、III组分别为8.8% (p > 0.05)。
结论。使用产钳是一种有效、安全的阴道手术分娩方法，不增加胎儿损伤，使用该方法时新生儿头部血肿发生频率比真空抽胎少3.5倍。使用产钳和胎儿真空抽提后的并发症(除了更多数量的阴道粘膜破裂的产钳病例)、失血、病程和产后在产科病房停留的时间具有可比性。
作者简介
Margarita Leonova
Maternity Hospital No. 13
Email: _margarita_@bk.ru
ORCID iD: 0000-0002-3813-2995
SPIN 代码: 8158-4744
MD, Head of the Maternity Department
俄罗斯联邦, Saint PetersburgNatalia Aganezova
North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: aganezova@mail.ru
ORCID iD: 0000-0002-9676-1570
SPIN 代码: 2961-5377
MD, PhD, DSci (Medicine), Associate Professor, Professor
俄罗斯联邦, Saint PetersburgSergey Aganezov
North-Western State Medical University named after I.I. Mechnikov
Email: aganezov@mail.ru
ORCID iD: 0000-0002-3523-9922
SPIN 代码: 8186-6778
MD, PhD, Associate Professor
俄罗斯联邦, Saint PetersburgElena Frederiks
Maternity Hospital No. 13
Email: evfrederiks@gmail.com
ORCID iD: 0000-0002-2513-6209
SPIN 代码: 1174-9903
Chief Physician
俄罗斯联邦, Saint PetersburgYulia Dymarskaya
North-Western State Medical University named after I.I. Mechnikov
Email: julia_dym@mail.ru
ORCID iD: 0000-0001-6027-6875
SPIN 代码: 4195-3410
MD, PhD, Assistant. The Department of Obstetrics and Gynecology
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