Buchmann E J, Pattinson R C
Department of Obstetrics and Gynaecology, University of the Witwaterstrand, South Africa.
Trop Doct. 2006 Jan;36(1):8-10. doi: 10.1258/004947506775598879.
Seventeen hospitals, from a range of health-care environments, participated in confidential enquiries of perinatal deaths resulting from labour-related intrapartum hypoxia. There were 102 deaths, including 22 stillbirths and 80 neonatal deaths. The mean birthweight was 3021 g. The active phase of the first stage of labour was prolonged beyond 12 h in six cases, and oxytocin was used for induction or augmentation in 10 women. Fetal heart decelerations were detected in 39 (49%) of the babies that went on to die in the neonatal period, and meconium passage was evident in 50 (63%). There were six breech presentations, and seven cases of cord prolapse. The majority of these deaths occurred in low-risk women with apparently uncomplicated labour. There appears to be a failure to detect or respond to evidence of fetal distress. Intrapartum care for all women in labour requires close attention to detail in monitoring fetal health.
来自一系列医疗环境的17家医院参与了对与分娩相关的产时缺氧导致的围产期死亡的保密调查。共有102例死亡，其中包括22例死产和80例新生儿死亡。平均出生体重为3021克。第一产程活跃期在6例中延长超过12小时，10名妇女使用了催产素进行引产或加强宫缩。在随后死于新生儿期的39名（49%）婴儿中检测到胎儿心率减速，50名（63%）婴儿有明显的胎粪排出。有6例臀位分娩，7例脐带脱垂。这些死亡大多数发生在分娩过程看似无并发症的低风险妇女中。似乎未能检测到胎儿窘迫的证据或对此做出反应。所有分娩妇女的产时护理都需要密切关注监测胎儿健康的细节。
