摘要
目的探讨新产程标准管理下总产程>24 h对母婴结局的影响。方法收集单活胎、足月、头位、总产程>24 h的初产妇109例,选择其中经阴道分娩的产妇作为观察组,随机抽取同期经阴道分娩总产程<24 h的产妇199例作为对照组,观察总产程>24 h的产妇中转剖宫产情况,比较2组产妇产时、产后情况,比较2组新生儿出生体质量、新生儿Apgar评分≤7分、脐动脉血pH<7.20及转新生儿重症监护病房(NICU)的比例,产后随访1年统计患病情况。结果109例总产程>24 h的产妇中转剖宫产7例,剖宫产发生率为6.90%;观察组潜伏期延长、分娩镇痛、产钳助产、产后出血、尿潴留比例均高于对照组,差异具有统计学意义(P<0.05);2组产褥感染率、新生儿出生体质量、新生儿Apgar评分≤7分发生率、脐动脉血pH<7.20及转NICU比例的组间比较,差异无统计学意义(P>0.05)。结论新产程标准下总产程>24 h初产妇经阴道分娩不会增加新生儿发病率及产褥感染比例,但会增加产钳助产、产后出血、尿潴留等比例。
Objective To explore the effect of total labor>24 h on maternal and infant outcomes under the new labor standards.Methods A total of 109 primiparas with single live births,full term,head position and total labor>24 h were collected.Among them,women who gave birth via vagina were selected as the observation group,and 199 women with total labor<24 h via vagina during the same period were randomly selected as controls group.Primiparas whose total labors>24 h and transferred to cesarean section were observed.The puerperium and postpartum conditions of primiparas,body weights of newborns,newborn Apgar scores≤7 points,umbilical artery blood pH<7.20,the portion of newborns who were transferred to neonatal intensive care unit(NICU)and postpartum follow-up for 1 year and statistics of the disease prevalence were compared between two groups.Results Seven primiparas were transferred to cesarean section,and the incidence rate was 6.90%.The latency,labor analgesia,forceps-assisted delivery,postpartum hemorrhage and urinary retention in observation group were significantly higher than those in the control group(P<0.05).There were no significant differences in puerperal infection rate,neonatal birth weight,incidence of neonatal Apgar score≤7 points,umbilical artery blood pH<7.20 and transfer to NICU between two groups(P>0.05).Conclusion Under the new labor standards,vaginal delivery of primiparas with total labor>24 h does not increase the incidence of neonatal morbidity and puerperal infection,but it will increase the incidence rate of maternal obstetric midwifery,postpartum hemorrhage and urinary retention.
作者
秦源坤
陆帆
龚晗
江智惠
郭丹
孙念梅
QIN Yuankun;LU Fan;GONG Han;JIANG Zhihui;GUO Dan;SUN Nianmei(Department of Obstetrics and Gynecology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550001,Guizhou,China)
出处
《贵州医科大学学报》
CAS
2021年第10期1179-1182,共4页
Journal of Guizhou Medical University
基金
贵州省科技计划项目[黔科合LH字(2017)7195]。
关键词
剖宫产术
阴道分娩
分娩并发症
窒息
新生儿
母婴
新产程
cesarean section
vaginal delivery
obstetric labor complication
asphyxia,newborns
mother and infant
new labor process
