足月单胎头位初产妇经阴试产失败相关因素的探讨

Term Single Fetal Head Primipara by Yin Trial-Produce Failure Related Factors

目的本研究分析足月头位单胎初产妇阴道试产失败的相关因素,为临床降低剖宫产率、促进阴道分娩提供可行措施。方法选取我院无妊娠并发症和合并症而阴道试产失败的初产妇200例,均足月头位单胎,作为观察组;选取同期足月头位单胎、无妊娠并发症和合并症但阴道试产成功的孕妇200例作为对照组。分析比较两组孕妇基本情况、体重变化情况、胎膜早破、分娩情况、新生儿体重等因素。结果观察组自然临产发动率、分娩镇痛率均显著低于对照组(P<0.05);年龄、孕周、妊娠期体重增加、临产时体重与BMI、新生儿体重、药物催产引产率均显著高于对照组(P<0.01)。两组的总临产方式存在统计学差异(P<0.01)。两组足月胎膜早破率无统计学差异(P>0.05)。Logistic回归分析显示孕妇年龄、身高、新生儿体重、球囊促宫颈成熟、分娩镇痛与阴道试产失败相关。结论在阴道分娩中,孕妇年龄、新生儿体重(g)、宫颈球囊促宫颈成熟属于危险因素,身高、分娩镇痛属于保护因素。

Objective The purpose of the study is to discuss and figure out the related factors which cause vaginal delivery failure for pregnant women with singleton and cephalic presentation,and to provide the solutions for decreasing the ratio of cesarean and to promote natural childbearing.Methods The study chooses 200 pregnant women without associated and postoperative pregnancy complications but failed in vaginal delivery as first group,who are all singleton and cephalic presentation;on the other hand,another 200 pregnant women with same physical conditions but vaginal delivery success are choosed as second group for comparison.The study mainly compares and get some factors,such as basic situation,weight variation situation,PROM,delivery condition,weights of babies and so on.Results It′s obvious that the natural labor wage rate and labor analgesia rate both are lower than the second group′s（P〈 0.05）;and the ages,gestational weeks,weight increase during pregnancy,BMI,weights of babies and so on are all lower than the second group′s.（P〈0.01）However,there are some differences between two groups on calculating the data（P〈0.05）.But there is no obvious difference between them on PPROM.（P〉0.05）The Logistic analysis of regression shows that the failure of vaginal delivery is related to pregnant ages of women,height,promote cervical mature.Conclusion During vaginal delivery,maternal age,birth weight（g）and Cervical ripening balloon promote cervical mature are all risky factors,but height,labor analgesia can be seen as protective factors.