摘要
目的探讨系统性产前评估在降低基层医院剖宫产率中的应用价值。方法回顾性分析2018年在该院产检并准备在该院分娩的妊娠38~41周临产前孕妇350例,根据入院先后顺序分为对照组(167例)和观察组(183例),其中对照组给予传统的产前评估,观察组给予系统性产前评估。观察并对比两组孕妇剖宫产率及母婴结局,采用Logistic回归模型分析影响剖宫产率的危险因素。结果观察组剖宫产率(44.26%)明显低于对照组(65.87%),差异有统计学意义(P<0.05);观察组胎儿窘迫、胆汁淤积症、产后出血及新生儿窒息发生率均显著低于对照组(均P<0.05);产前评估分、医保、城市、希望的分娩方式、认为对胎儿安全、认为对母亲安全、认为有利于孩子健康且聪明的分娩方式及认为自然分娩影响性生活会对剖宫产率产生影响(P<0.05);产前评估分≥24分、有医保、认为自然分娩对母亲安全及认为自然分娩影响性生活是影响剖宫产率的独立危险因素,而希望的分娩方式为自然分娩为其保护因素(P<0.05)。结论系统性产前评估在剖宫产分析中可行性良好,能够对孕妇制定切实可行的分娩方案,同时,对无医学指征且有意愿选择剖宫产的孕妇加强干预,最大限度降低剖宫产发生率。
Objective To explore the application value of systematic prenatal assessment in reducing cesarean section rate in primary hospitals.Methods In 2018,350 pregnant women of 38-41 gestational weeks were selected from the First People’s Hospital of Fuyang District,then they were divided into control group(167 women)and observation group(183 women)according to the sequence of admission,the pregnant women in control group were given routine prenatal assessment,and the patients in observation group were given systematic prenatal assessment.Cesarean section rates,maternal and infantile outcomes in the two groups were observed and compared.Logistic regression model was used to analyze the risk factors of cesarean section rate.Results Cesarean section rate in observation group was 44.26%,which was statistically significantly lower than that in control group(65.87%)(P<0.05).The incidence rates of fetal distress,cholestasis,postpartum hemorrhage,and neonatal asphyxia in observation group were statistically significantly lower than those in control group(P<0.05).The influencing factors of cesarean section rate included prenatal assessment score,medical insurance,place of residence,hopeful delivery mode,consideration of fetal safety,consideration of maternal safety,consideration of delivery mode beneficial to the children,and consideration of sexual life affected by spontaneous labor(P<0.05);the independent risk factors of cesarean section rate included prenatal assessment score≥24,having medical insurance,consideration of spontaneous labor beneficial to mothers,and consideration of sexual life affected by spontaneous labor;hopeful delivery mode was the protective factor(P<0.05).Conclusion The feasibility of systematic prenatal assessment in cesarean section is good,feasible delivery scheme can be developed,intervention among the pregnant women without medical indications and having willing to select cesarean section should be enhanced to reduce cesarean section rate to the utmost extent.
作者
汪敏敏
孙素芳
何妍春
马欢临
WANG Min-Min;SUN Su-Fang;HE Yan-Chun(Department of Obstetrics,the First People’s Hospital of Fuyang District,Hangzhou,Zhejiang 311400,China)
出处
《中国妇幼保健》
CAS
2020年第24期4650-4653,共4页
Maternal and Child Health Care of China
基金
杭州市富阳区科技计划项目(2018SK014)。
关键词
系统性产前评估
剖宫产
护理
母婴结局
分娩方式
Systematic prenatal assessment
Cesarean section
Nursing
Maternal and infantile outcomes
Delivery mode
