新产程标准管理下1089例自然分娩初产妇的产程特点分析

Analysis of labor progression characteristics of 1089 nulliparas managed by the new partogram

目的分析在新产程标准管理下初产妇自然分娩的产程特点。方法收集2015年1月1日至2016年5月31日于中山大学附属第一医院住院并自然分娩的1 089例初产妇的临床资料(包括产程图),计算宫口每扩张1.0 cm所需的时长,以2.0 cm(34.6%,377/1 089)或3.0 cm(21.7%,236/1 089)为宫口扩张的起始观察点,观察并分析产妇从起始观察点至宫口开全的产程曲线。结果(1)宫口的扩张速度随宫口开大而增快,宫口从5.0 cm开大至6.0 cm之间的增速最明显,>3.0 cm/h。(2)产程曲线中,宫口扩张观察起始点为2.0 cm时,在宫口扩张至5.0 cm后加速明显;起始观察点为3.0 cm时,在宫口扩张至5.5 cm前加速明显,此后曲线走势陡峭。结论本研究中初产妇的宫口扩张速度迅速;宫口扩张从起始观察点至宫口开全的产程曲线中,均可见加速明显的阶段,且曲线走势陡峭。

Objective To analyze labor progression characteristics among nulliparas and provide reference to labor progress management. Methods A retrospective study was conducted on 1 089 women who went for vaginal delivery at the First Affiliated Hospital, Sun Yet-San University from January 1st, 2015 to May 31th, 2016. The duration of cervical dilation from 1.0 cm to the next and the process of initial cervical dilation (2.0 cm or 3.0 cm) to full cervical dilation of nulliparas were analyzed. Results The cervical dilation speed was accelerating with the progress of labor. The rate of cervical dilation changed fastest between 5.0-6.0 cm dilation, which was more than 3.0 cm/hour. With regard to labor curves, at admission of 2.0 cm cervical dilation, it rose dramatically from 5.0 cm dilation. At admission of 3.0 cm dilation, it presented approximately linear rising before 5.5 cm dilation, then became steeper. Conclusions The cervical dilation speed is fast. Both labor curves of initial cervical dilation (2.0 cm or 3.0 cm) to full cervical dilation show obvious acceleration stage with steep slope.