摘要
目的 研究新产程标准下产房顺产中转剖宫产的危险因素及母婴结局。方法 2020年1~12月,选取罗湖区妇幼保健院280例自愿要求阴道试产的产妇作为研究对象。按照不同产程标准分为对照组和观察组各140例。对照组采用旧产程标准处理,观察组采用新产程标准处理。比较两组产妇的产钳助产、中转剖宫产、人工破膜、使用缩宫素的差异,采用Logistic回归分析影响新旧产程标准下产房顺产中转剖宫产的危险因素,并比较两组产妇的母婴结局。结果 两组产妇的产钳助产率比较差异无统计学意义(P>0.05);观察组产妇的中转剖宫产、使用缩宫素及人工破膜发生率分别为9.29%、6.43%和5.00%,明显低于对照组的17.86%、15.00%和12.14%,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,产程标准是产房顺产中转剖宫产的独立保护因素(P<0.05),而产程异常、头先露异常、胎儿窘迫、社会因素是产房顺产中转剖宫产的独立危险因素(P<0.05);两组产妇的产后尿潴留、产褥感染及新生儿肺炎发生率比较差异均无统计学意义(P>0.05);观察组产妇的产后出血发生率为10.00%,明显高于对照组的3.57%,差异有统计学意义(P<0.05)。结论 新产程标准的实施可明显降低人工破膜率、宫缩素使用率及中转剖宫产率,且不影响母婴结局;产程异常、头先露异常、胎儿窘迫、社会因素是中转剖宫产的独立危险因素。
Objective To study the risk factors and maternal and infant outcomes of conversion to cesarean section from spontaneous delivery in delivery room under the new labor process standard. Methods A total of 280 pregnant women who voluntarily asked for vaginal delivery in Luohu Maternal and Child Health Hospital were selected as the research objects from January 2020 to December 2020. They were divided into a control group and an observation group according to different stages of labor, with 140 women in each group. The control group was treated with the old labor process standard, and the observation group was treated with the new labor process standard. The differences of forceps delivery, conversion to cesarean section, artificial rupture of membranes, and use of oxytocin between the two groups were analyzed. Logistic regression analysis was used to analyze the risk factors of conversion to cesarean section from spontaneous delivery under the new and old labor process standards, and the maternal and infant outcomes of the two groups were compared. Results There was no significant difference in forceps delivery rate between the two groups(P>0.05). The incidences of conversion to cesarean section, oxytocin use, and artificial rupture of membranes in the observation group were 9.29%, 6.43%, and 5.00%, respectively, which were significantly lower than 17.86%,15.00%, and 12.14% in the control group(P<0.05). Logistic regression analysis showed that the standard of labor process was an independent protective factor for the conversion to cesarean section from spontaneous delivery(P<0.05). Abnormal labor process, abnormal head presentation, fetal distress, and social factors were the independent risk factors of cesarean section(P<0.05). There was no significant difference in the incidence of postpartum urinary retention, puerperal infection, and neonatal pneumonia between the observation group and the control group(P>0.05). The incidence of postpartum hemorrhage in the observation group was 10.00%, which was significantly h
作者
赖建芬
熊莉芳
张哲
黄倩戎
LAI Jian-fen;XIONG Li-fang;ZHANG Zhe;HUANG Qian-rong(Department of Obstetrics and Gynecology,Luohu Maternal and Child Health Hospital,Shenzhen 518000,Guangdong,CHINA)
出处
《海南医学》
CAS
2022年第6期751-753,共3页
Hainan Medical Journal
关键词
新产程标准
旧产程标准
顺产
中转剖宫产
危险因素
母婴结局
New labor process standard
Old labor process standard
Spontaneous delivery
Conversion to cesarean section
Risk factors
Maternal and infant outcomes
