Barwin B N, Dempsey A, Ivey B
Can Med Assoc J. 1978 Feb 4;118(3):292-4.
To ensure an optimum result in pregnancy it is essential that the physician be alert in the antenatal period to recognize those women and their babies who are at risk during labour. Premature labour, with its attendant risk of respiratory distress syndrome in the newborn, continues to be an important factor in perinatal morbidity and mortality. Early recognition of predisposing factors and the judicious use of myometrial inhibiting agents have helped to reduce the incidence of fetal prematurity in these cases. A long interval between rupture of the membranes and delivery continues to be a danger to both mother and fetus. Delivery is recommended when gestation is beyond 36 weeks or when there are signs of incipient infection, and once labour has begun antibiotics should be used prophylactically. Failure of labour to progress should be recognized and managed aggressively in its early stages. Amniotomy and oxytocin infusion have reduced considerably the incidence of prolonged labour and its risks to both mother and fetus. The role of intrapartum monitoring of the fetal heart rate, measurement of the pH in the fetus's scalp blood and assessment of amniotic fluid is discussed, as is the monitoring of maternal well-being.
为确保孕期取得最佳结果，医生在产前阶段必须保持警惕，识别出那些在分娩期间有风险的孕妇及其胎儿。早产及其伴随的新生儿呼吸窘迫综合征风险，仍然是围产期发病率和死亡率的重要因素。早期识别诱发因素并明智地使用子宫肌层抑制药物，有助于降低这些病例中胎儿早产的发生率。胎膜破裂与分娩之间的间隔时间过长，仍然对母亲和胎儿都构成危险。当孕周超过36周或出现早期感染迹象时，建议进行分娩，一旦分娩开始，应预防性使用抗生素。应在早期阶段识别并积极处理产程进展不顺利的情况。人工破膜和缩宫素输注已大大降低了产程延长的发生率及其对母亲和胎儿的风险。本文讨论了产时胎儿心率监测、胎儿头皮血pH值测量、羊水评估以及产妇健康监测的作用。
