Can Fam Physician. 1990 Oct;36:1735-40.
Inappropriate concern with perinatal asphyxia, based on false notions about causes, may be behind the decision of some family physicians to avoid obstetrics. Asphyxia can cause motor or mental deficits, but only if the insult was severe and prolonged (when there will be evidence of hypoxia in systems other than the CNS). Even abnormal CNS signs do not necessarily reflect clinically important neurologic damage. Intrapartum care has much less impact on neonatal outcome than previously believed, and most bad outcomes have their origins in events occuring long before the onset of labour and outside the detection capabilities of current technology. Nevertheless, family physicians require resuscitation skills because vigorous, effective management of even very hypoxic neonates can improve and normalize outcome.
一些家庭医生之所以决定回避产科工作，可能是因为他们错误地认为围产期窒息是一个问题，但实际上这种担心是不恰当的。窒息可能导致运动或智力缺陷，但前提是窒息的程度很严重且持续时间很长（此时中枢神经系统以外的其他系统就会出现缺氧的证据）。即使中枢神经系统出现异常也不一定反映出临床上有重要的神经损伤。与之前人们的看法相比，分娩期的护理对新生儿结局的影响要小得多，而且大多数不良结局都起源于分娩开始很久之前的事件，这些事件超出了当前技术的检测能力。尽管如此，家庭医生仍需要掌握复苏技术，因为即使是非常严重缺氧的新生儿，强有力、有效的管理也能改善和恢复其结局。
