摘要
目的探讨新产程标准下剖宫产术后再次妊娠阴道分娩(VBAC)孕妇的妊娠结局。方法对照组108例VBAC产妇采用Friedman产程标准;观察组为239例VBAC产妇,采用新产程标准。回顾并分析两组产妇相关临床资料,比较两组分娩情况、产程时间、产时干预措施、分娩并发症和新生儿结局差异。结果观察组自然分娩率73.2%,妊娠中转剖宫产24.3%;对照组自然分娩率61.1%,妊娠中转剖宫产37.0%,两组比较差异有统计学意义(P<0.05)。与对照组比较观察组妊娠活跃期时间明显缩短(P<0.001),第一、第二产程时间明显延长(P<0.001)。观察组缩宫素使用、人工破膜、地西泮使用均显著低于对照组(P<0.05)。两组在产后并发症及新生儿不良结局方面比较差异无统计学意义(P>0.05)。结论新产程标准放宽了第一、第二产程,使VBAC产妇充分试产,降低了剖宫产率,减少产程中医疗干预,且并未影响围产结局。
Objective To explore the pregnancy outcome of vaginal birth after cesarean section(VBAC)under new labor standards.Methods Control group included 108 cases VBAC maternal under Friedman labor standard delivery,while 239 cases of VBAC maternal adopted new labor standards.Retrospectively analyzed the delivery way,labor time,interventions during delivery,pregnancy complication and neonatal outcome were compared.Results The natural delivery rate and cesarean section during pregnancy in observation group was 73.2%and 24.3%,while 61.1%and 37.0%in the control group,with statistically significant difference between the two groups(P<0.05).Compared to control group,the duration of pregnancy was significantly shortened(P<0.001)and the first and second labor time was significantly longer(P<0.001)in observation group.The use of oxytocin,artificial rupture of fetal membranes and use of diazepam in observation group was significantly lower than that in control group(P<0.05).However,no significant difference was found regarding the incidence of postpartum complications and adverse neonatal outcomes(P>0.05).Conclusions The new labor standard extend the first and second stage of labor so that gives VBAC maternal full trial production.The new standard reduced the rate of cesarean section and labor intervention,meanwhile did not affect perinatal outcome.
作者
刘兰
王金莲
张立敏
王勇娟
赵永隆
LIU Lan;WANG Jinlian;ZHANG Limin;WANG Yongjuan;ZHAO Yonglong(Obstetrical Department One,The Seventh People's Hospital of Hebei,Dingzhou,Hebei 073000,China;Operating Room,The Seventh People's Hospital of Hebei,Dingzhou,Hebei 073000,China)
出处
《安徽医药》
CAS
2019年第5期939-941,共3页
Anhui Medical and Pharmaceutical Journal
基金
河北省保定市科技局项目(16ZF204)
关键词
剖宫产后阴道分娩
指南
试分娩
自然分娩
产程
第一
产程
第二
产程
第三
缩宫素
妊娠结局
Vaginal birth after cesarean
Guidebooks
Trial of labor
Natural childbirth
Labor stage,first
Labor stage,second
Labor stage,third
Ocytocin
Pregnancy outcome
