足月妊娠干预性计划分娩与剖宫产率相关性探讨

The Relationship between the Interventional Plan of Full-term Pregnancy and the Cesarean Section Rate

目的分析及总结足月妊娠干预性计划分娩的妊娠结局,并探讨其与剖宫产发生率的相关性。方法选取该院妇产科在2017年3月—2019年3月期间收治的448例足月初产妇的临床资料为研究对象,按照是否实施计划分娩干预措施分为两组各224例。研究组实施干预性计划分娩,参照组未实施任何计划分娩干预措施,回顾比较两组产妇剖宫产发生率。结果研究组82例产妇发生剖宫产,剖宫产率为36.61%,参照组共49例产妇发生剖宫产,剖宫产发生率21.88%,研究组剖宫产发生率明显高于参照组,对比差异有统计学意义(χ^2=11.7483,P=0.000 6<0.05);两组剖宫产产妇滞产、羊水粪染及胎儿宫内窘迫等发生率差异无统计学意义(P>0.05);研究组剖宫产产妇无过期妊娠,参照组剖宫产7例(14.29%)产妇发生过期妊娠,对比差异有统计学意义(χ^2=12.375,P=0.000 <0.05)。研究组剖宫产产妇中48例(58.54%)产妇具有头盆不称指征,参照组剖宫产产妇中19例(38.78%)具有头盆不称指征,研究组明显高于参照组,对比差异有统计学意义(χ^2=4.793,P=0.028<0.05)。两组产后出血、胎儿肺炎、新生儿窒息与产褥感染等产后母婴并发症发生率差异无统计学意义(P>0.05)。结论足月妊娠干预性计划分娩会增加剖宫产率,对产后母婴并发症无明显影响。对于孕37~41周在无任何产科并发症以及羊水胎盘功能正常前提下,不宜过早干预,严格地控制剖宫产率。

Objective To analyze and summarize the pregnancy outcome of full-term pregnancy interventional planned delivery and to explore its correlation with the incidence of cesarean section. Methods The clinical data of 448 full-term primiparas who were admitted to the Department of Obstetrics and Gynecology in our hospital from March 2017 to March 2019 were selected as the study subjects. According to whether or not to implement the planned delivery intervention, 224 cases were divided into two groups. The study group implemented an interventional plan for delivery, and the reference group did not implement any planned labor interventions. The incidence of cesarean section in the two groups was compared. Results A total of 82 women in the study group had cesarean section, and the cesarean section rate was 36.61%. In the reference group, 49 cases of cesarean section occurred in the women, and the incidence of cesarean section was 21.88%. The incidence of cesarean section in the study group was significantly higher than that in the reference group. There was significant statistical difference between the two groups (χ^2=11.748 3, P=0.000 6<0.05). There was no statistically significant difference in the incidence of cesarean section, amniotic fluid fecal infection and intrauterine distress (P>0.05). In the study group, there was no overdue pregnancy in the cesarean section, and 7 cases (14.29%) of the cesarean section in the reference group had an overdose pregnancy. The difference was statistically significant (χ^2=12.375, P=0.000 <0.05). In the study group, 48 cases (58.54%) of the women who had cesarean section had no indication of head basin, and 19 cases (38.78%) of the cesarean section of the reference group had no indication of head basin, and the study group was significantly higher than the reference group. The difference was statistically significant (χ^2=4.793, P=0.028<0.05). There was no significant difference in the incidence of postpartum maternal and child complications between postpartum hemorrhage, fetal pneumonia, neonatal asphyxia and puerperal infection, and the difference was not statistically significant (P>0.05). Conclusion Interventional planned delivery in term pregnancy will increase cesarean section rate and have no significant effect on postpartum maternal and child complications. For the pregnancy 37~41 周 without any obstetric complications and normal function of the amniotic fluid placenta, it is not appropriate to intervene too early to strictly control the cesarean section rate.