无痛分娩下新产程时限管理产程对母儿结局的临床分析

Clinical analysis on the effect of new birth process time limit management on maternal and infantile outcomes under painless labor

目的探讨新产程标准管理产程对母儿结局的影响。方法对照组为阴道试产的238例单胎足月初产妇,采用传统Friedman产程标准;观察组为阴道试产的209例单胎足月初产妇,采用新产程时限标准。回顾并分析两组产妇分娩相关的临床资料,比较两组孕妇母儿结局的差异。结果观察组剖宫产率低于对照组,产程总干预率低于对照组,总产程时间高于对照组,差异均有统计学意义(P<0.05);观察组产后出血、产后尿潴留及巨大儿分娩率稍高于对照组,但差异无统计学意义(P>0.05);观察组会阴侧切率稍低于对照组,两组比较差异无统计学意义(P>0.05)。结论新产程标准放宽潜伏期时限,使产妇充分试产,降低了剖宫产率,减少产程中医疗干预,两组围产结局差异无统计学意义。

Objective To explore the influence of new birth process standard management on the outcomes of mothers and infants. Methods Control group included 238 singleton full2term primiparous women trying vaginal delivery using traditional Friedman birth process standard; observation group included 209 singleton full-term primiparous women trying vaginal defivery using new birth process standard. The clinical data about maternal delivery in the two groups were retrospectively analyzed, and the differences of maternal and infantile out- comes between the two groups were compared. Results The cesarean section rate in observation group was lower than that in control group, the total intervention rate of birth process was lower than that in control group, and the total labor time in observation group was higher than that in control group with statistically significant difference （P〈0. 05） ; the incidence rates of postpartum hemorrhage, postpartum urinary re- tention and macrosomia delivery in observation group were slightly higher than those in control group without statistically significant difference （P〉0. 05 ） ; the rate of perineal episiotomy in observation group was slightly lower than that in control group without statistically significant difference （P〉0. 05 ） . Conclusion New labor standard widens latent time limit to make fully maternal vaginal delivery attempt and reduce cesarean section rate, as well as reduce medical intervention during the production process, while the difference of perinatal outcomes was no significant between the two groups.