子痫前期患者阴道试产中转剖宫产的危险因素

Risk factors of vaginal trial production transferring to caesarean section in patients with preeclampsia

目的分析子痫前期患者阴道试产中转剖宫产的危险因素。方法选择2016年1月至2020年1月武穴市第一人民医院收治的100例子痫前期阴道试产中转剖宫产产妇作为观察组,并纳入同期子痫前期患者阴道试产分娩成功的80例产妇作为对照组。比较两组产妇的临床诊断指征及临床资料,采用Logistic回归分析法分析影响患者中转剖宫产的危险因素。结果观察组产妇产前定期检查率为21.00%,明显低于对照组的65.00%,差异有统计学意义(P<0.05);观察组产妇的新生儿体质量为(3.28±0.23)kg、负性情绪、高血压家族史及不良生活方式占比分别为59.00%、49.00%、48.00%,明显高于对照组的(3.05±0.24)kg、15.00%、12.50%、11.25%,差异均有统计学意义(P<0.05);两组产妇的年龄、体质量指数、身高、产次、孕周、流产次数、文化程度、多胎妊娠、居住地比较差异均无统计学意义(P>0.05);两组产妇的产程停滞延长率、胎儿紧迫率、妊娠并发症率、瘢痕子宫率、头盆不称率、胎盘因素等临床指征比较差异均有统计学意义(P<0.05),而引产失败、社会因素比较差异均无统计学意义(P>0.05);经Logistic回归分析结果显示,产前定期检查、新生儿体质量、有负性情绪、有高血压家族史、有不良生活方式均是导致阴道试产转剖宫产的独立影响因素(P<0.05)。结论子痫前期阴道试产转剖宫产与多种因素有关,临床应根据相关因素制定合理有效措施,以提高阴道试产成功率。

Objective To analyze the risk factors of vaginal trial production transferring to caesarean section in patients with preeclampsia.Methods A total of 100 pregnant women with preeclampsia who underwent vaginal trial production transferring to caesarean section in Wuxue First People's Hospital from January 2016 to January 2020 were selected as the observation group,and 80 pregnant women with preeclampsia who were successfully delivered by vaginal trial production during the same period were included as the control group.The clinical diagnostic indications and clinical data of the two groups were compared,and the risk factors affecting the conversion to cesarean section were analyzed by Logistic regression analysis.Results The rate of regular prenatal examinations in the observation group was 21.00%,which was significantly lower than 65.00%in the control group(P<0.05).The weight of newborns in the observation group was(3.28±0.23)kg,and the proportion of negative emotions,family history of hypertension,and adverse lifestyle was 59.00%,49.00%,and 48.00%,respectively,which was significantly higher than(3.05±0.24)kg,15.00%,12.50%,and 11.25%in the control group(P<0.05).There was no significant difference in age,body mass index,height,number of births,gestational weeks,number of abortions,educational level,multiple pregnancy and residence between the two groups(P>0.05).There was significant difference between the two groups in clinical indications such as stagnation and prolongation,fetal urgency,pregnancy complications,scarred uterus,cephalopelvic imbalance,and placental factors(P<0.05),but there was no significant difference in induced labor failure and social factors(P>0.05).Logistic regression analysis showed that regular prenatal examination,weight of newborns,negative emotions,family history of hypertension,and bad lifestyle were all independent factors leading to the conversion of vaginal trial production to caesarean section(P<0.05).Conclusion The transfer from vaginal trial producation to cesarean section in patients with preeclampsia is related to many factors.Clinically,reasonable and effective measures should be formulated according to relevant factors to improve the success rate of vaginal trial production.