新产程标准下阴道助产中转剖宫产多因素分析

Multi-factor Analysis of Cesarean Section in Vaginal Midwifery under New Labor Standard

目的探讨新产程标准下阴道助产中转剖宫产对母婴结局的影响结果。方法采用回顾性统计分析方法,对比该院产科实行旧产程标准的2016年1—12月间(对照组)以及实行新产程标准的2017年1—12月间(观察组)住院分娩产妇剖宫产率以及经阴道助产中转剖宫产的影响因素和母婴结局。结果观察组阴道助产中转剖宫产总剖宫产率为35.00%,对照组为40.91%,观察组明显低于对照组(χ^2=14.904,P<0.0001);观察组阴道助产中转剖宫产产妇中符合剖宫产手术指征率为90.02%,对照组为86.11%,观察组明显高于对照组(χ^2=5.357,P=0.021);观察组阴道助产中转剖宫产产妇中非医学指征其他因素占比为9.98%,对照组为13.89%,观察组明显低于对照组(χ^2=5.357,P=0.021);观察组发生产妇分娩及产后并发症及新生儿窒息率均明显低于对照组,差异有统计学意义(χ^2=4.043、4.628,P=0.044、0.031)。结论新产程标准实行后阴道助产中转剖宫产率明显降低,非医学指征及其他因素导致中转剖宫产率也明显下降,产妇母婴并发症发生率明显降低。

Objective To investigate the effect of cesarean section on the outcome of maternal and pediatric outcomes under vaginal midwifery under the new labor standard.Methods A retrospective statistical analysis method was used to compare the old labor standards of the obstetrics department from January to December 2016(control group)and the new labor standards from January to December 2017(observation group).The factors affecting the cesarean section rate of hospital delivery and the vaginal midwifery transfer cesarean section and maternal and child outcomes.Results In the observation group,the cesarean section rate of cesarean section was 35.00%in the vaginal midwifery,and 40.91%in the control group.The observation group was significantly lower than the control group(χ^2=14.904,P<0.000 1).The vaginal midwifery in the observation group was converted into cesarean section.Among the women,the indication rate for cesarean section was 90.02%,and that of the control group was 86.11%.The observation group was significantly higher than the control group(χ^2=5.357,P=0.021).The observation group had vaginal midwifery and cesarean section.The other factors accounted for 9.98%,and the control group was 13.89%.The observation group was significantly lower than the control group(χ^2=5.357,P=0.021);the observation group produced women with delivery and postpartum complications and neonatal asphyxia rate were obvious.Compared with the control group,the above differences were statistically significant(χ^2=4.043,4.628,P=0.044,P=0.031).Conclusion After the implementation of the new labor standard,the vaginal delivery rate of vaginal delivery was significantly reduced.Non-medical indications and other factors led to a significant decrease in the rate of cesarean section.The incidence of maternal and child complications was significantly reduced.