新产程标准对孕产妇分娩方式和母婴结局的影响

The effect of new labor process standard on delivery mode and maternal and infant outcome

目的探讨新产程标准管理对孕产妇分娩方式和母婴结局的影响。方法选取2015年1至6月唐县人民医院(保定市第四中心医院)收治的500例单胎头位阴道分娩及中转剖宫产产妇设为对照组,另选取2018年1至6月收治的500例单胎头位阴道分娩及中转剖宫产产妇设为观察组。分析对比两组产后出血率、产妇发热率、新生儿窒息率、NICU入住率、产钳助产率、中转剖宫产率及中转剖宫产指征。结果观察组自然分娩率显著高于对照组,中转剖宫产率、产钳助产率显著低于对照组,差异均具有统计学意义(P<0.05)。观察组的胎儿窘迫、相对头盆不称、跃期停滞、潜伏期延长发生率均显著低于对照组,差异具有统计学意义(P<0.05)。观察组的产妇发热率、NICU入住率均显著低于对照组,差异具有统计学意义(P<0.05);两组产后出血和新生儿窒息发生率比较,差异无统计学意义(P>0.05)。结论新产程标准对产程时限给予适当的延长,给予产妇更为充分的试产机会,在一定意义上促进阴道分娩,减少了剖宫产率,并无增加母儿不良结局。

Objective To explore the effect of new standard management of labor process on delivery mode and maternal and infant outcome.Methods 500 cases of single-fetal head vaginal delivery and intermediate cesarean delivery admitted to Tangxian People′s Hospital(Baoding Fourth People′s Hospital)from January to June 2015 were selected as the control group,and another 500 cases from January to June 2018 as the observation group.The postpartum hemorrhage rate,maternal febrile rate,neonatal asphyxia rate,NICU occupancy rate,forceps assisted rate,intermediate cesarean section rate and transit cesarean section indications were analyzed and compared between the two groups.Results The natural delivery rate of the observation group was significantly higher than that of the control group,the rate of conversion to cesarean section and forceps delivery were significantly lower than those of the control group,the differences were statistically significant(P<0.05).The incidences of fetal distress,relative cephalopelvic disproportion,climacteric arrest and prolonged latency in the observation group were significantly lower than those in the control group(P<0.05).The maternal fever rate and NICU occupancy rate of the observation group were significantly lower than those of the control group,the difference was statistically significant(P<0.05);there was no significant difference in the incidence of postpartum hemorrhage and neonatal asphyxia between the two groups(P>0.05).Conclusions The new labor standard provides appropriate extension of labor time,giving puerpera more sufficient opportunity for trial labor,which promotes vaginal delivery and reduces the rate of cesarean section to a certain extent,and does not increase the adverse outcomes of mother and child.