新产程管理模式下第二产程时限对分娩结局的影响

The influence of the duration of the second stage of labor on the labor outcome in the new labor management mode

目的探讨新产程管理模式下第二产程时限对母婴结局的影响。方法选择2018年1~12月在我院住院并按新产程标准处理产程的经阴道分娩的初产妇5256例,并根据第二产程持续时间(t)将其分为三组:0 h<t<2 h为Ⅰ组,2 h≤t<3 h为Ⅱ组,t≥3 h为Ⅲ组,比较三组产妇产后出血率、产钳助产率及新生儿窒息率之间的差异。结果Ⅱ组产后出血率(11.19%)和产钳助产率(10.49%)均显著高于Ⅰ组(分别为4.95%,3.46%)(P<0.05);Ⅲ组产后出血率(31.56%)和产钳助产率(38.22%)均显著高于Ⅰ组和Ⅱ组(P<0.05);三组新生儿窒息率差异均无统计学意义(P>0.05)。结论采用新产程管理模式处理第二产程时,应及时识别异常产程及头盆关系,积极管理,最大限度减少母婴不良结局的发生。

Objective To explore the effect of the duration of the second stage of labor on the outcome of mother and child under the new mode of labor management.Methods 5256 primiparas who underwent transvaginal delivery according to the new labor standard were selected in our hospital from January to December 2018.They were divided into three groups according to the duration of the second stage of labor(t):groupⅠ:0 h<t<2 h,groupⅡ:2 h≤t<3 h,groupⅢ:t≥3 h.The difference in the postpartum hemorrhage rate,forceps delivery rate and neonatal asphyxia rate among the three groups was compared.Results The postpartum hemorrhage rate(11.19%)and forceps delivery rate(10.49%)in groupⅡwere significantly higher than those in groupⅠ(4.95%,3.46%,respectively),(P<0.05).The postpartum hemorrhage rate(31.56%)and forceps delivery rate(38.22%)in groupⅢwere significantly higher than those in groupsⅠandⅡ,(P<0.05).The difference in neonatal asphyxia rate among the three groups were not statistically significant.Conclusion When adopting the new labor management model to deal with the second stage of labor,the abnormal labor and the relationship of head and pelvis should be timely identified and management should be taken actively,to minimize the occurrence of adverse outcomes of mother and child.