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分析我院近３年来住院分娩的足月新生儿４１６８例（除畸形儿）中２７４例新生儿窒息的产科原因，以求降低围产儿死亡率和提高产科质量。结果显示：新生儿窒息发生率６．５７％，窒息病死率８．７６％，占围产儿死亡的首位。２７４例新生儿窒息中脐带因素占２３％，居首位，死亡占２５％；胎盘功能不全占１９％，死亡占３３％，居新生儿窒息死亡的首位；不恰当的产式（包括吸引产、钳产、剖宫产）占１４％；宫缩过强过频占１２％；２例因剖宫产胎儿娩出前使用氯胺酮致新生儿重度窒息。提示：新生儿窒息是围产儿死亡的重要原因之一，应做好围产期保健，预防并及时处理妊娠合并症，注意胎心监护，维持正常的自然产程，避免宫缩过强过频及阴道多次助产和／或多种助产，选择最佳产式结束分娩，适当放宽臀位剖宫产指征，注意分娩过程中接近胎儿娩出时应禁用麻醉镇静剂
To analyze the obstetric reasons of 274 newborns with asphyxia in 4168 full-term newborns hospitalized in our hospital in recent 3 years in order to reduce perinatal mortality and improve obstetric quality. The results showed that: neonatal asphyxia 6.57%, asphyxia mortality 8.76%, accounting for the first death of perinatal children. Among the 274 newborns with asphyxia, umbilical cord factors accounted for 23%, ranking the top with 25% of deaths; placental insufficiency accounting for 19% and deaths accounting for 33%, ranking first in neonatal asphyxia death; inappropriate mode of production , Forceps, cesarean section) accounted for 14%; uterine contractions too strong accounted for 12%; 2 cases of cesarean section before delivery of ketamine caused severe neonatal asphyxia. Tip: Asphyxia neonatorum is one of the important causes of perinatal death, should be good at perinatal care, prevention and timely treatment of pregnancy complications, attention to fetal heart rate monitoring, to maintain normal natural labor, to avoid too frequent contractions and Vaginal multiple midwifery and / or a variety of midwifery, choose the best type of end-childbirth, appropriate relaxation of breech cesarean indications, pay attention to the process of delivery close to the fetus should be banned from the delivery of narcotic sedatives