国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (1): 105-109.doi: 10.12280/gjfckx.20240851

• 产科生理及产科疾病:综述 • 上一篇    下一篇

早产的产程特点及产时管理

耿昊, 陈叙()   

  1. 300100 天津市中心妇产科医院产科
  • 收稿日期:2024-09-18 出版日期:2025-02-15 发布日期:2025-02-14
  • 通讯作者: 陈叙,E-mail:chenxuaa2665@126.com

The Characteristics of Premature Labor and Intrapartum Management

GENG Hao, CHEN Xu()   

  1. Department of Obstetrics, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300100, China
  • Received:2024-09-18 Published:2025-02-15 Online:2025-02-14
  • Contact: CHEN Xu, E-mail: chenxuaa2665@126.com

摘要:

早产儿产程时限特点的研究对于改善围产期母婴结局至关重要。目前关于早产的产程时限及产时相关处理措施尚无统一标准。早产孕妇的产程进展与足月孕妇存在差异,早产初产妇的活跃期起始点较早,且产程时限较短。早产可分为自发性早产和医源性早产,但关于早产催引产人群的产程曲线管理,目前几乎没有数据支持。早产儿的产时胎心监护特点与足月儿不同,胎心率基线较高,变异减少,且胎心加速出现频率低、持续时间短、波动幅度低。早产儿脐带结扎的方法已从立即断脐转变为胎盘输血,包括延迟脐带结扎和挤压脐带,其中延迟脐带结扎对早产儿具有更大的意义。早产儿的围产结局与产时的临床处理息息相关,产科医生在临床中应给予个体化监护,以便进行适当的临床评估与处理,减少母婴不良结局的发生。

关键词: 早产, 分娩发动, 胎儿监测, 妊娠结局, 脐带结扎

Abstract:

The research on the characteristics of labor duration in preterm births is crucial for improving perinatal outcomes for both mothers and infants. At present, there is no unified standard for the duration of labor and related management strategies in preterm deliveries. The progression of labor in preterm pregnancies differs from that in term pregnancies. Preterm primiparas often experience an earlier onset of the active phase and a shorter overall labor duration. Preterm labor can categorized in spontaneous preterm birth and iatrogenic preterm birth, but there is currently a lack of data supporting the management of labor curves in women undergoing induced preterm labor. Intrapartum fetal heart rate monitoring in preterm infants differs from that in term infants, characterized by a higher baseline fetal heart rate, reduced variability, and less frequent, shorter duration, and lower amplitude accelerations. Umbilical cord clamping practices have shifted from immediate clamping to strategies that emphasize placental transfusion, including delayed umbilical cord clamping and cord milking, with delayed umbilical cord clamping offering greater benefits to preterm infants. Perinatal outcomes in preterm infants are closely related to intrapartum management. Obstetricians should provide individualized monitoring in clinical practice to allow for appropriate clinical assessment and intervention, thereby reducing the incidence of adverse maternal and neonatal outcomes.

Key words: Preterm labor, Labor onset, Fetal monitoring, Pregnancy outcome, Umbilical cord clamping