新产程管理模式下活跃期不同时限对母婴结局的影响

Effect of different time limits of active period on maternal and infant outcomes under the new labor management mode

目的探讨新产程管理模式下活跃期不同时限对母婴结局的影响。方法回顾性分析2018年7月~2019年7月我院妇产科收治的360例足月初产妇的临床资料,根据活跃期的不同进行分组,将其中180例活跃期<4 h的产妇纳入对照组,将另外180例活跃期≥4 h的产妇纳入观察组。比较两组产妇围术期指标、新生儿分娩后1、5 min Apgar评分、妊娠结局以及妊娠并发症发生情况。结果观察组产妇产后出血量少于对照组,总产程时间长于对照组,差异有统计学意义(P<0.05);两组新生儿分娩后5 min的Apgar评分与分娩后1 min比较,差异无统计学意义(P>0.05);观察组产妇中转剖宫产率低于对照组,差异有统计学意义(P<0.05);两组羊水粪染及新生儿窒息发生率比较,差异无统计学意义(P>0.05)。结论新产程管理模式以活跃期停滞时间>4 h再考虑是否作为手术的指征,可使产妇有充分的时间试产,降低剖宫产率,改善围术期指标,利于产妇预后,推荐临床推广应用。

Objective To explore the effect of different time limits of active period on the maternal and infant outcomes under the new labor management model.Methods Retrospective analysis of the clinical data of 360 full-term primiparas treated to the department of obstetrics and gynecology in our hospital from July 2018 to July 2019.Grouped according to the different active periods,180 pregnant women with active period<4 h were included in the control group,and another 180 pregnant women with active period≥4 h were included in the observation group.The perioperative indicators,the Apgar scores at 1 minute and 5 minutes after delivery,the pregnancy outcomes and complications were compared between the two groups.Results The maternal postpartum hemorrhage volume in the observation group was lower than that in the control group,and the total duration of labor was longer than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the Apgar score of newborns between the two groups 5 minutes after delivery and 1 minute after delivery(P>0.05).The rate of maternal conversion tocesarean section in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of amniotic fluid fecal infection and neonatal asphyxia between the two groups(P>0.05).Conclusion The new labor management mode takes the active period>4 h as the treatment time limit to allow the pregnant women to have sufficient time for trial delivery,reduce the cesarean delivery rate,improve the perioperative index,and benefit the prognosis of the pregnant women.It is recommended of clinical application.