摘要
目的:分析新产程标准对经阴道试产中转剖宫产指征及妊娠结局的影响。方法:选取本院经阴道试产的产妇作为观察对象,按照自愿选择的原则分成原产程及新产程组,比较两组间中转剖宫产率、剖宫产前试产时间及剖宫产指征的差异,分析两组间产后出血、产后尿潴留、新生儿窒息及巨大儿发生率的不同。结果:原标准转剖宫产比率高于新标准组(χ~2=19.238、P=0.000),而剖宫产前试产时间两组无差异(P=0.359)。在剖宫产指征方面,潜伏期延长、活跃期停滞、相对头盆不称及胎儿窘迫等发生比率原标准组高于新标准组(P=0.011、0.005、0.000、0.015),宫内感染及社会因素比率在两组间无差异(P=0.161、0.078)。产后出血及产后尿储留比率原产程低于新产程组(P=0.027、0.008),新生儿窒息及巨大儿发生比率两组间无差异(P=0.535、0.305)。结论:新产程标准可以降低经阴道试产中转剖宫产率,改变剖宫产指征构成,同时也可能会增加产后出血及尿潴留的风险。
Objective： To analyze the influence of New Labor Standards on indications of from planning vaginal delivery to cesarean delivery and outcomes of pregnancy. Methods： The pregnant women intended to vaginal delivery in Chinese Medicine Hospital of Changxing County were divided into chosen Old Labor Standards group （group A ）and chosen New Labor Standards group（group B） according to willing of pregnant women. The rate of cesarean delivery, the time before cesarean delivery, and the indication of cesarean delivery were compared between the tow groups. The rate of postpartum hemorrhage, postpartum urinary retention, neonatal asphyxia and macrosomia were also compared between the tow groups. Results： The rate of cesarean delivery of women in group A was significant higher than that of women in group B（P =0.00）, but there were no significant difference on the time before cesarean delivery between the two groups （P=0.36）. The indication of cesarean delivery, such as rate of latency prolong, stagnation of active period, relative cephalopelvic disproportion, and fetal distress of women in group A were significant higher than those of women in group B （P=0.01, 0.01, 0.00, 0.02）, The ratio of intrauterine infection and rate of cesarean delivery for social factors were no significant difference between the two groups （P = 0.16, 0.08）. The rate of postpartum hemorrhage and postpartum urinary retention in group A were significant lower than those in group B （P = 0.03, 0.01）, and there were no significant difference on rate of neonatal asphyxia and macrosomia （P = 0.54, 0.31）. Conclusion： The New Labor Standards can reduce the rate of cesarean delivery from planning vaginal delivery intrapartum, and change indications of cesarean delivery, but may increase the risk of postpartum hemorrhage and urinary retention.
出处
《中国计划生育学杂志》
2017年第2期101-103,111,共4页
Chinese Journal of Family Planning
关键词
分娩过程
剖宫产术
妊娠结局
新产程标准
Labor, Cesarean delivery
Pregnancy outcome
Standard of new laber stage
