催产素点滴引产失败及分娩结局的影响因素

Influencing factors of failure of labor induction by oxytocin and delivery outcome

目的探究催产素点滴引产失败及分娩结局的影响因素,为规范孕期管理及催产素点滴引产的过程管理提供依据。方法本研究自行设计资料收集表,回顾性收集2014—2018年在中日友好医院产科进行催产素点滴引产的1705名孕妇的资料,分析催产素点滴引产失败及其分娩结局的影响因素。结果本研究共纳入1705名孕产妇的数据。多因素分析显示,羊水污染、巨大儿、催产素点滴时长为引产失败的独立影响因素(P<0.05)。催产素点滴引产时长与分娩方式、新生儿体重、产后出血量有关系,差异有统计学意义(P<0.01)。分析经催产素点滴引产分娩结局为剖宫产的原因,"胎儿宫内窘迫"和"头盆不称"2个因素占比最高。结论催产素点滴引产失败的影响因素主要为羊水污染、巨大儿等,并且随着引产进程的推进影响因素会逐渐增加,进而使得自然分娩率降低。因此应加强孕期管理,控制孕期体重及胎儿体重,减少妊娠合并症;加强临床对催产素点滴引产的规范管理,做好催产素点滴的宣教指导工作,提高催产素点滴引产的阴道分娩率。

Objective To explore the influencing factors of the failure of labor induction by oxytocin and delivery outcome, and provide a basis for standardizing pregnancy management and process management of labor induction by oxytocin.Methods Using a self-designed data collection form, the data of 1 705 pregnant women who underwent labor induction by oxytocin in the Department of Obstetrics of China-Japan Friendship Hospital from 2014 to 2018 were retrospectively collected, and the influencing factors of the failure of labor induction by oxytocin and the outcome of delivery were analyzed.Results A total of 1 705 primary mothers were included in the study. Multiple factor analysis show that, amniotic fluid pollution, macrosomia, and the duration of labor induction by oxytocin were independent influencing factors for the failure of labor induction by oxytocin. The duration of labor induction by oxytocin was related to the method of delivery, weight of the newborn, and amount of postpartum hemorrhage, and the difference was statistically significant (P<0.01) . The outcome of delivery labor induction by oxytocin was the cause of cesarean delivery, and "intrauterine fetal distress" and "cephalopelvic disproportion" accounted for the highest proportion.Conclusions The main influencing factors for the failure of labor induction by oxytocin are amniotic fluid pollution, macrosomia, etc., and the influencing factors will gradually increase with the process of labor induction, thereby reducing the natural delivery rate. Therefore, it is necessary to strengthen pregnancy management, control pregnancy weight and fetal weight, and reduce pregnancy complications. It is also necessary to strengthen clinical management of labor induction by oxytocin, provide sound education and guidance for labor induction by oxytocin, and increase the vaginal delivery rate after labor induction by oxytocin.