Menticoglou S M, Manning F, Harman C, Morrison I
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, Canada.
Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):906-12. doi: 10.1016/0002-9378(95)90364-x.
The second stage of labor has been thought of as a time of particular asphyxial risk for the fetus. This perceived risk has been invoked to justify arbitrary time limits and high rates of operative vaginal delivery. The purpose of this study was to determine whether perinatal outcome worsened as the second stage lengthened.
Over a 5-year period at one university teaching hospital, 6041 nulliparous women reached the second stage of labor with a live singleton cephalic fetus with birth weight > or = 2500 gm. A retrospective review of perinatal morbidity and mortality was performed and the results related to the duration of the second stage.
The second stage lasted > 3 hours in 11% of nulliparous women and > 5 hours in 2.7%. There were no perinatals death unrelated to anomaly. There was no significant relationship between second-stage duration and low 5-minute Apgar score, neonatal seizures, or admission to the neonatal intensive care unit.
Operative intervention in the second stage is not warranted merely because some set number of hours has elapsed.
分娩第二产程一直被认为是胎儿发生窒息风险特别高的时期。这种被感知到的风险被用来为设定任意的时间限制和高比例的阴道助产分娩提供理由。本研究的目的是确定围产期结局是否会随着第二产程延长而恶化。
在一所大学教学医院的5年时间里，6041例初产妇进入分娩第二产程，单胎头位活产胎儿，出生体重≥2500克。对围产期发病率和死亡率进行回顾性分析，并将结果与第二产程的持续时间相关联。
11%的初产妇第二产程持续时间超过3小时，2.7%的初产妇超过5小时。没有与畸形无关的围产儿死亡。第二产程持续时间与5分钟Apgar评分低、新生儿惊厥或入住新生儿重症监护病房之间没有显著关系。
不能仅仅因为已经过去了一定的小时数就进行第二产程的手术干预。
