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既往有假临产病史患者的产科结局

Obstetric outcome of patients with a previous episode of spurious labor.

作者信息

Arulkumaran S, Michelsen J, Ingemarsson I, Ratnam S S

出版信息

Am J Obstet Gynecol. 1987 Jul;157(1):17-20. doi: 10.1016/s0002-9378(87)80337-x.

Abstract

The obstetric performance of patients admitted with spurious labor was evaluated. The incidence of fetal distress in labor was significantly higher in those who had spurious labor (16.7%) than in those who were established in labor within 24 hours of admission (3.8%). An equivocal or ominous fetal heart rate trace on admission was related to the occurrence of fetal distress in labor in both the spurious labor group and the normal labor group. Positive predictive value of a normal test was low in the spurious labor group. Obstetric interventions such as augmentation (35.7%) and operative deliveries (41.0%) were significantly higher in the spurious labor group than in the normal labor group (19.7% and 18.8%, respectively). The induction rate in the spurious labor group was 15.5%. The use of oxytocin for augmentation and induction of labor seems to contribute to the increased incidence of fetal distress and operative deliveries in the spurious labor group. The spurious labor group also had a higher incidence of fetal distress than the control group even among the patients who did not receive oxytocin. The results suggest that patients with an episode of spurious labor constitute a high-risk group with a considerable risk of fetal distress and obstetric interventions in subsequent labor.

摘要

对因假临产入院的患者的产科表现进行了评估。假临产患者分娩时胎儿窘迫的发生率(16.7%)显著高于入院后24小时内确诊临产的患者(3.8%)。入院时胎心监护结果不明确或异常与假临产组和正常临产组分娩时胎儿窘迫的发生均有关。假临产组正常检查结果的阳性预测值较低。假临产组的产科干预措施如产程加速(35.7%)和手术分娩(41.0%)显著高于正常临产组(分别为19.7%和18.8%)。假临产组的引产率为15.5%。使用缩宫素进行产程加速和引产似乎导致了假临产组胎儿窘迫和手术分娩发生率的增加。即使在未使用缩宫素的患者中,假临产组胎儿窘迫的发生率也高于对照组。结果表明,有假临产经历的患者构成了一个高危群体,在随后的分娩中有相当大的胎儿窘迫风险和产科干预风险。

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