Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnan...Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.展开更多
Prolonged obstructed labor is a critical intrapartum emergency. This intricacy is, however, unusual as a primary presentation of a giant bladder calculus. We report a case of a 25-year-old Para 6 + 1, who presented wi...Prolonged obstructed labor is a critical intrapartum emergency. This intricacy is, however, unusual as a primary presentation of a giant bladder calculus. We report a case of a 25-year-old Para 6 + 1, who presented with a history of labor pains of 72 hours duration. She had background lower urinary tract symptoms with supra-pubic swelling and hematuria of 2 years duration. She had a single antenatal visit at 32 weeks however;no obstetric ultrasound scan was done before she went into labor. Examination revealed a highly placed fetal head with increase fetal heart rate. There was a hard mass bulging under the anterior vaginal wall. The diagnosis was a prolonged obstructed labor secondary to bladder mass with fetal distress was made. She had a caesarean section (CS) with the delivery of fresh stillborn. The bi-manually palpable bladder mass persisted post-CS. Her abdominopelvic ultrasound scan and abdominal X-ray post-CS revealed giant vesical calculus with obstructive uropathy. Urine microscopy culture and sensitivity yielded E. coli sensitive to Ciprofloxacin;other laboratory investigations were normal. She was treated for UTI and 2 weeks post-CS, she had opened cystolithotomy. The stone weighed 536 g. Her postoperative recovery was uneventful.展开更多
目的:探讨产时超声对第二产程延长初产妇分娩方式的指导价值,以及对母婴结局的影响。方法:选取2022年7月至2023年12月于广州市妇女儿童医疗中心分娩且出现第二产程延长的初产妇100例作为研究对象。按随机数表法分为对照组和观察组,各50...目的:探讨产时超声对第二产程延长初产妇分娩方式的指导价值,以及对母婴结局的影响。方法:选取2022年7月至2023年12月于广州市妇女儿童医疗中心分娩且出现第二产程延长的初产妇100例作为研究对象。按随机数表法分为对照组和观察组,各50例。对照组行单纯阴道指诊指导分娩,观察组在对照组的基础上行产时超声检查。比较两组产妇分娩方式、产妇结局及新生儿结局。结果:观察组产妇剖宫产、产钳助娩和会阴Ⅲ~Ⅳ度裂伤发生率较对照组低,阴道顺产率较对照组高,产后2 h出血量较对照组更少,差异均具有统计学意义(P<0.05);两组新生儿出生体质量比较,差异无统计学意义(P>0.05);观察组新生儿出生1 min、5 min Apgar评分更高,需呼吸支持及入住新生儿重症监护病房(NICU)的新生儿例数更少,差异均具有统计学意义(P<0.05)。结论:对第二产程延长的初产妇通过阴道指诊联合产时超声指导分娩,可降低剖宫产率,减少产后出血量,改善会阴裂伤程度及新生儿结局。展开更多
文摘Objective:To discuss the effect of prolonged second stage of labor on maternal and neonatal outcomes.Methods:A total of 101 primiparas with the length of second stage of labor longer than 2 h were selected and pregnant women with the length less than 2 h served as control.The maternal and neonatal outcomes of two groups were observed and compared.Results:A total of 62.1%(18/11) with the length of second stage of labor between 120 min and 180 min,46.7%(28/32) between 181 min and 240 min and 12 longer than 241 min underwent vaginal delivery.The longer the length of second stage of labor,the lower score of Apgar scale for infants in 1 min,and the higher the incidence of asphyxia.But there was no difference in scale in 5 min.As second stage of labor prolonged,the incidences of cesarean section and of postpartum hemorrhage increased. Conclusions:Almost half of puerperas with the length of second stage of labor longer than 2 h underwent vaginal delivery.The prolonged second stage of labor can decrease the score of Apgar scale in 1 min,increase the incidence of asphyxia,but has no effect on scale in 5 min.It still need more evidence from evidence medicine to definition of time and treatment of second stage of labor.
文摘Prolonged obstructed labor is a critical intrapartum emergency. This intricacy is, however, unusual as a primary presentation of a giant bladder calculus. We report a case of a 25-year-old Para 6 + 1, who presented with a history of labor pains of 72 hours duration. She had background lower urinary tract symptoms with supra-pubic swelling and hematuria of 2 years duration. She had a single antenatal visit at 32 weeks however;no obstetric ultrasound scan was done before she went into labor. Examination revealed a highly placed fetal head with increase fetal heart rate. There was a hard mass bulging under the anterior vaginal wall. The diagnosis was a prolonged obstructed labor secondary to bladder mass with fetal distress was made. She had a caesarean section (CS) with the delivery of fresh stillborn. The bi-manually palpable bladder mass persisted post-CS. Her abdominopelvic ultrasound scan and abdominal X-ray post-CS revealed giant vesical calculus with obstructive uropathy. Urine microscopy culture and sensitivity yielded E. coli sensitive to Ciprofloxacin;other laboratory investigations were normal. She was treated for UTI and 2 weeks post-CS, she had opened cystolithotomy. The stone weighed 536 g. Her postoperative recovery was uneventful.
文摘目的:探讨产时超声对第二产程延长初产妇分娩方式的指导价值,以及对母婴结局的影响。方法:选取2022年7月至2023年12月于广州市妇女儿童医疗中心分娩且出现第二产程延长的初产妇100例作为研究对象。按随机数表法分为对照组和观察组,各50例。对照组行单纯阴道指诊指导分娩,观察组在对照组的基础上行产时超声检查。比较两组产妇分娩方式、产妇结局及新生儿结局。结果:观察组产妇剖宫产、产钳助娩和会阴Ⅲ~Ⅳ度裂伤发生率较对照组低,阴道顺产率较对照组高,产后2 h出血量较对照组更少,差异均具有统计学意义(P<0.05);两组新生儿出生体质量比较,差异无统计学意义(P>0.05);观察组新生儿出生1 min、5 min Apgar评分更高,需呼吸支持及入住新生儿重症监护病房(NICU)的新生儿例数更少,差异均具有统计学意义(P<0.05)。结论:对第二产程延长的初产妇通过阴道指诊联合产时超声指导分娩,可降低剖宫产率,减少产后出血量,改善会阴裂伤程度及新生儿结局。
