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缩宫素使用及剂量差异对 VBAC 孕妇妊娠结局的影响。

Influence of Oxytocin Usage and Dose Difference During Delivery on Pregnancy Outcome of VBAC Pregnant Women.

机构信息

Three Treatment Areas of Obstetrics, Changchun Maternity Hospital, Changchun 130042, China.

出版信息

Contrast Media Mol Imaging. 2022 Aug 9;2022:6038924. doi: 10.1155/2022/6038924. eCollection 2022.

Abstract

In order to explore the influence of oxytocin usage and dose difference during delivery on the pregnancy outcome of VBAC pregnant women, the clinical data of 166 VBAC pregnant women from January 2017 to March 2020 are retrospectively analyzed. All women are divided into different groups according to the usage of oxytocin during delivery and the oxytocin dose difference. Binary logistic regression is used to analyze the factors affecting the pregnancy outcome of pregnant women with VBAC. The gestational weeks and the thickness of the lower uterine segment in the oxytocin group are significantly more than those in the nonoxytocin group ( < 0.05). The time of the first stage of labor, second stage of labor, and total stage of labor in the oxytocin group are significantly longer than the nonoxytocin group ( < 0.05). The proportion of entering NICU in the oxytocin group is significantly lower than the nonoxytocin group ( < 0.05). There is no significant difference in labor duration and pregnancy outcome between low-dose and medium-dose oxytocin groups. Binary logistic regression analysis shows that prenatal BMI <30 kg/cm, gestational age ≤40 weeks, history of vaginal delivery, uterine expansion, and admission to hospital are the influencing factors for pregnancy success of pregnant women with VBAC. The usage of oxytocin in VBAC pregnant women during delivery may increase the duration of labor. For those with poor uterine contraction, oxytocin can be increased to 4∼18 mU/min to speed up the labor process, without increasing the risk of adverse pregnancy outcomes.

摘要

为了探讨分娩时使用催产素及剂量差异对 VBAC 孕妇妊娠结局的影响,回顾性分析 2017 年 1 月至 2020 年 3 月间 166 例 VBAC 孕妇的临床资料。所有孕妇均根据分娩时是否使用催产素及催产素剂量差异分为不同组,采用二项 logistic 回归分析影响 VBAC 孕妇妊娠结局的因素。催产素组的孕周及下段子宫厚度均显著大于非催产素组(<0.05)。催产素组的第一产程、第二产程及总产程时间均显著长于非催产素组(<0.05)。催产素组进入 NICU 的比例显著低于非催产素组(<0.05)。低剂量和中剂量催产素组的产程时间及妊娠结局比较,差异均无统计学意义。二项 logistic 回归分析显示,产前 BMI<30kg/cm、孕周≤40 周、阴道分娩史、子宫扩张及入院是 VBAC 孕妇妊娠成功的影响因素。分娩时使用催产素可能会增加产程时间,对于宫缩不良者,可将催产素增加至 4~18mU/min 以加速产程,不增加不良妊娠结局的发生风险。

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