以新产程标准为指导的产程处理对分娩结局的影响研究

发布时间：2018-04-22 22:17

本文选题：分娩 + 产道　；参考：《中国全科医学》2017年15期

【摘要】：目的探讨以新产程标准为指导处理产程对分娩结局的影响。方法以2015年1—8月于中山大学附属第三医院实施新产程标准的709例初产妇为研究组,以2014年1—8月本院实施传统产程标准的819例初产妇为对照组,比较两组分娩方式、产后出血发生率、新生儿不良结局(Apgar评分异常、脐动脉血气p H值7.0、羊水粪染)发生率、产程时间;观察研究组中传统产程标准诊断为产程曲线异常初产妇的分娩结局。结果研究组自然分娩率高于对照组,剖宫产率低于对照组(P0.01);两组产妇产后出血发生率、1 min Apgar评分异常发生率、脐动脉血气pH值7.0发生率、羊水粪染发生率比较,差异无统计学意义(P0.05);两组5 min Apgar评分均无异常;研究组第一产程、第二产程、总产程时间长于对照组(P0.05)。研究组中按传统产程标准诊断为潜伏期延长(16 h)、活跃期延长(8 h)、第二产程延长(2 h)的初产妇自然分娩率分别为45.8%(11/24)、69.2%(9/13)、84.1%(37/44)。结论以新产程标准为指导处理产程,能降低剖宫产率,促进自然分娩,不增加产后出血、产钳助产、新生儿不良结局等风险。
[Abstract]:Objective to explore the influence of labor process on delivery outcome under the guidance of new labor procedure. Methods 709 primiparas who implemented the new labor procedure standard in the third affiliated Hospital of Sun Yat-sen University from January to August 2015 were used as the study group, and 819 primipara women who implemented the traditional labor procedure standard in our hospital from January to August 2014 as the control group. The delivery modes of the two groups were compared. The incidence of postpartum hemorrhage, abnormal Apgar score of neonatal adverse outcome, umbilical artery blood gas pH value 7.0, feces staining of amniotic fluid) and the time of labor were observed. The traditional standard of labor process in the study group was diagnosed as the delivery outcome of primipara with abnormal labor process curve. Results the natural delivery rate in the study group was higher than that in the control group, the cesarean section rate was lower than that in the control group (P 0.01), the incidence of postpartum hemorrhage in the two groups was abnormal in 1 min Apgar score, the incidence of umbilical artery blood gas pH value was 7. 0, and the incidence of amniotic fluid feces staining was higher. There was no significant difference between the two groups in 5 min Apgar scores. The first stage of labor, the second stage of labor and the total duration of labor in the study group were longer than those in the control group (P 0.05). In the study group, the natural delivery rates of primipara diagnosed according to the traditional criteria of labor were prolonged by 16 hours, active period by 8 hours, second stage by 2 hours). The natural delivery rate of primipara was 45.8%, respectively. The rate of natural delivery was 45.8%, respectively. Conclusion under the guidance of the standard of new labor procedure, the cesarean section rate can be reduced, the spontaneous delivery can be promoted, and the risk of postpartum hemorrhage, forceps midwifery and adverse outcome of newborn can not be increased.
【作者单位】：中山大学附属第三医院产科;
【分类号】：R714

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