PREVENTION OF PROLONGED LABOUR
PREVENTION OF PROLONGED LABOUR
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DOI：
10.1136/bmj.2.5655.477
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发表时间：
1969-01-01
影响因子：
105.7
通讯作者：
GALLAGHER, JT
中科院分区：
文献类型：
--
作者：
ODRISCOLL, K;JACKSON, RJA;GALLAGHER, JT
一项对1 000名连续无孕分娩的前瞻性研究表明，积极的分娩管理可以确保每名妇女在24小时内分娩。强调的重要性，正确的初步诊断劳动的基础上客观的标准。羊膜切开术后输注催产素被认为可以模拟正常分娩的进程，除非早期就有明显的迹象。催产素的剂量仅受胎儿窘迫的限制，除非三个流行的谬论被否定，否则催产素不能有效地使用。第一，产程延长往往是头盆不称的表现;第二，催产素可使过期妊娠子宫破裂;第三，低渗和高渗子宫活动之间存在有效的治疗区别。适当监督的刺激对母亲和婴儿都是安全的，它消除了枕后位的问题，导致产钳分娩的急剧下降，并且避免了大量镇痛的需要。
A prospective study of 1,000 consecutive primigravid deliveries has shown that active management in labour can ensure that every woman is delivered within 24 hours. Emphasis is laid on the importance of a correct initial diagnosis of labour based on objective criteria. Amniotomy followed by oxytocin infusion is advocated to simulate the progress of normal labour unless this is evident from an early stage.Oxytocin, the dose of which is limited only by foetal distress, cannot be used effectively unless three popular fallacies are rejected. Firstly, that prolonged labour is often an expression of cephalo-pelvic disproportion; secondly, that oxytocin may rupture the primigravid uterus; and, thirdly, that there is a valid therapeutic distinction between hypotonic and hypertonic uterine action.Stimulation, properly supervised, is safe to mother and child, it eliminates the problem of occipitoposterior position, results in a sharp decline in forceps delivery, and obviates the need for massive analgesia.