新旧产程标准对子痫前期孕妇的诊疗影响分析

目的讨论新旧产程标准对子痫前期孕妇分娩过程的影响.方法选取2017年1月至2018年1月间本院产科收治的127例子痫前期产妇为观察对象并分为两组,旧产程组采用Friedman产程管理,新产程组采用2014版新产程标准.比较两组的产程时间、产钳助产率、剖宫产率、催产素使用率情况,母婴并发症(产后出血、会阴撕裂、胎儿窘迫和新生儿窒息)等情况.结果新产程组潜伏期为(22.52±4.37) h,第一产程为(23.11±5.28)h,明显长于旧产程组,差异有统计学意义(P<0.05).新产程组中42例行剖宫产,产钳助产5例,催产素使用33例,均低于旧产程组,且差异有统计学意义(P<0.05).新旧产程组产后出血、会阴撕裂、胎儿窘迫和新生儿窒息等发生率差异无统计学意义(P>0.05).结论对子痫前期孕妇,采用新产程管理标准,能够有效降低剖宫产率、产钳和催产素的使用率.但是对子痫前期孕妇,还需要注意产程延长可能导致的子痫前期患者病情加重的问题,一旦出现血压升高,仍然必须尽快结束妊娠.

Objective To discuss the effect of new and old labor standards on the delivery process of women with preeclampsia. Methods 127 cases of preeclampsia women admitted to obstetrics department of our hospital from January 2017 to January 2018 were selected as observation objects and divided into two groups. Friedman labor management was adopted in the old labor group and the new labor group adopted the new labor standard of 2014. The duration of labor,forceps midwifery rate, cesarean section rate, utilization rate of oxytocin and maternal and infant complications(postpartum hemorrhage, perineal tear,fetal distress and neonatal asphyxia)were compared between the two groups. Results The incubation period was (22.52±4.37)h in the new labor group and(23.11±5.28) h in the first labor group, which was significantly longer than that in the old labor group (P<0.05). 42 cases of cesarean section, 5 cases of forceps midwifery and 33 cases of oxytocin in the new labor process group were lower than those in the old labor process group, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of postpartum hemorrhage, perineal tear, fetal distress and neonatal asphyxia between the old and new labor groups(P>0.05). Conclusion The new management standard of labor process can effectively reduce the rate of cesarean section, forceps and oxytocin in pregnant women with preeclampsia. However, for preeclampsia women,attention should also be paid to the possible aggravation of preeclampsia patients caused by prolonged labor. Once the blood pressure rises, the pregnancy must still be terminated as soon as possible.