新产程第二产程标准临床应用观察

Clinical application and observation of new labor standards in the second stage of labor

目的观察比较新、旧产程第二产程标准临床应用的优劣,进一步验证新产程标准在临床上的适用性。方法收集2012年1月~2014年1月于我院分娩的年龄22~30岁、头位、骨盆外测量正常、估计胎儿体重<4000 g的初产妇50例为对照组,按旧产程标准(第二产程>2 h)诊断为第二产程延长。随机选择2015年7月~2016年6月在我院分娩的初产妇(选择标准同上)50例为观察组,按新产程标准(第二产程>3 h)诊断为第二产程延长。比较两组的剖宫产率、阴道助产率、产后出血率、新生儿重度窒息率。结果观察组剖宫产率明显低于对照组,而观察组阴道助产率明显高于对照组,两组分娩方式比较,差异有统计学意义(P<0.05)。两组产后出血率和新生儿重度窒息率比较,差异无统计学意义(P>0.05)。结论新产程标准的应用降低了第一胎的剖宫产率,提高阴道分娩率,而且不增加产后出血及新生儿轻、重度窒息率。

Objective To observe and compare the advantages and disadvantages of clinical application of a new and old labor standards in the second stage of labor,and to further verify the applicability of the new labor standard in clinical.Methods 50 primiparas with age of 22-30 years old,the head position and the normal measurement of the pelvis,the estimated fetal weight less than 4000 g from January 2012 to January 2014 in our hospital were selected as control group,the second stage of labor（more than 2 h） was diagnosed as prolonged second stage of labor according to the old labor standards;50 primiparas（selection criteria as above mentioned） from July 2015 to June 2016 of our hospital were selected as observation group,the second stage of labor（more than 3 h） was diagnosed as prolonged second stage of labor according to the new labor standards.The difference of the tate of cesarean section,vaginal delivery rate,postpartum hemorrhage and neonatal severe asphyxia in two groups were compared.Results The rate of cesarean section in the observation group was significantly lower than that in the control group,and the rate of vaginal birth in the observation group was significantly higher than that in the control group,the difference was statistically significant（P〈0.05）.There was no significant difference in the rate of postpartum hemorrhage and neonatal severe asphyxia between the two groups（P〉0.05）.Conclusion The application of the new labor standard reduces the rate of cesarean section,increases the rate of vaginal delivery,and does not increase the incidence of postpartum hemorrhage and mild and severe neonatal asphyxia.