摘要
目的探讨采用新产程标准后导致初产妇产钳助产的相关因素,并分析产钳助产后母儿的结局。方法选择2017年1月至2022年1月在我院产钳助产的足月初产妇743例作为观察组,选择产钳助产后的下一位自然分娩的足月初产妇743例作为对照组。对两组产妇产前临床资料及围产结局进行分析;采用病例对照研究和多因素Logistic回归分析产钳助产的相关因素。结果第二产程时间采用新产程标准是产钳助产的独立保护因素(B值-0.050,OR 0.951,95%CI 0.947~0.956),年龄≥35岁(B值1.172,OR 3.228,95%CI 1.257~8.291)、妊娠期糖尿病(GDM)(B值1.519,OR 4.567,95%CI 2.055~10.151)、胎位异常(B值1.118,OR 3.059,95%CI 1.347~6.946)和巨大儿(B值1.520,OR 4.574,95%CI 1.527~13.702)是产钳助产的独立危险因素,均与产钳助产密切相关(P<0.05)。观察组会阴重度裂伤(包括会阴III~IV度裂伤)发生率、产后出血发生率均显著高于对照组(P<0.05);观察组新生儿面部擦伤、新生儿窒息、新生儿肺炎、新生儿转NICU患病率均显著高于对照组(P<0.05)。结论第二产程时间采用新产程标准的足月初产妇产钳助产几率降低,年龄≥35岁、GDM、胎位异常、巨大儿足月初产妇产钳助产几率增高。产钳助产对母儿结局有重要影响。
Objective To explore the influence factors for the forceps delivery of primiparas after the use of new labor criteria,and analyze maternal and neonatal outcomes affected by consequent forceps delivery.Methods A total of 743 primiparas who were delivered by forceps in our hospital,from January 2017 to January 2022 were selected as the study group.A total of 743 natural full-term delivery primiparas after forceps delivery were selected as the control group.The prenatal clinical data and perinatal outcome of the above two groups were analyzed;The related risk factors of forceps delivery were analyzed by case-control study and multivariate Logistic regression.Results The adoption of the new standard for the second stage of labor was an independent protective factor for forceps assisted delivery(B value:-0.050,OR 0.951,95%CI 0.947~0.956);Age≥35years(B value 1.172,OR 3.228,95%CI 1.257~8.291)、GDM(B value 1.519,OR 4.567,95%CI 2.055~10.151)、abnormal fetal position(B value 1.118,OR 3.059,95%CI 1.347~6.946)and macrosomia(B value 1.520,OR 4.574,95%CI 1.527~13.702)were independent risk factors for forceps delivery.They were all closely related to the forceps delivery(P<0.05).The study group was characterized with significantly higher incidence of acute third-and fourth-degree obstetric lacerations and postpartum hemorrhage comparing with those in the control group(P<0.05).The study group was characterized with significantly higher incidence of prevalence of neonatal facial abrasions、neonatal asphyxia、neonatal pneumonia and neonatal transfer to NICU comparing with those in the control group(P<0.05).Conclusion The probability of forceps assisted delivery decreases for full-term primiparas who adopts the new labor standard during the second stage of labor,and the probability of forceps assisted delivery increases for full-term primiparas with age≥35 years old,GDM,abnormal fetal position and giant baby.Forceps assisted delivery has an important effect on maternal and infant outcomes.
作者
邓洪
罗丹
魏璐
王涛
刘兴会
Deng Hong;Luo Dan;Wei Lu(Department of Obstetrics and Gynecology,Chengdu Women s and Children s Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu,Sichuan 610091,China.)
出处
《四川医学》
CAS
2022年第12期1227-1231,共5页
Sichuan Medical Journal
关键词
新产程标准
产钳助产
阴道分娩
初产妇
母儿结局
new labor criteria
forceps delivery
vaginal delivery
primiparas
maternal and neonatal outcomes
