产钳助产对降低剖宫产率的意义

Significance of assisted vaginal delivery by forceps in vaginal delivery

目的探讨产钳助产技术对降低剖宫产率的意义。方法 2014年北京市海淀区妇幼保健院为降低剖宫产率进行产钳助产规范化培训,将2014年分娩的13 952例孕妇作为研究组,2013年分娩的11 588例孕妇作为对照组,对两组孕产妇并发症、分娩方式及母儿结局进行回顾性分析。结果 (1)2014年剖宫产率由2013年的38.8%下降至29.3%,两者比较差异有统计学意义(P<0.01);(2)与2013年比较,2014年产钳助产率显著升高(9.40%vs 5.85%),差异有统计学意义(P<0.01);(3)2014年的产后出血率、会阴Ⅲ度以上裂伤、新生儿窒息率与2013年比较,差异无统计学意义。结论加强产钳助产培训,提高产钳助产技术,在阴道助产指征明确和条件具备的情况下选择产钳助产术,可有效地降低剖宫产率,减少母婴并发症,促进自然分娩。

Objective To evaluate the clinical significance of assisted vaginal delivery by forceps in vaginal delivery.Methods In order to reduce the caesarean section rate,assisted vaginal delivery by forceps training was carried out in Beijing Haidian District Maternal and Children Health Care Hospital from 2014. 13 952 pregnant women who delivered in 2014 were included in study group and another 11 588 pregnant women who delivered in 2013 were included in the control group. The complications,delivery mode and maternal and neonatal outcomes in all subjects were recorded and analyzed. Results（ 1） The caesarean section rate in study group was statistically significantly lower than that in the control group（ 29. 3% vs 38. 8%,P〈0. 01）;（ 2） The forceps vaginal delivery rate was significantly higher in study group than that in the control group（ 9. 40% vs 5. 85%,P〈0. 01）;（ 3） No statistically significant difference was observed in the frequency of postpartum hemorrhage,perineal laceration Ⅲ degree and over,and neonatal asphyxia. Conclusions Strengthening forceps delivery skills among obstetricians may help to reduce the caesarean section rate and promote vaginal delivery without increasing the maternal and neonatal complications.