新旧产程标准对母儿结局的影响

发布时间：2018-06-21 06:09

本文选题：新产程标准 + 产后并发症　；参考：《中国妇产科临床杂志》2017年06期

【摘要】：目的探讨新旧产程标准对母儿结局的影响。方法采用回顾性分析的方法,将按照旧产程标准管理的孕妇5 385例设为对照组,按照新产程标准管理的孕妇6 836例设为研究组,排除经产妇、瘢痕子宫、双胎妊娠、前置胎盘、骨盆狭窄、胎儿畸形及合并严重妊娠合并症等具有绝对剖宫产指征的病例。比较两组孕妇一般资料、剖宫产原因、孕妇分娩结局及新生儿结局。结果研究组和对照组剖宫产率分别为25.19%(1 722/6 836)和28.79%(1 550/5 385),两组比较,差异有统计学意义(P0.05),其中研究组因活跃期停滞行剖宫产742例(43.09%),对照组757例(48.83%);研究组因第二产程延长行剖宫产64例(3.72%),对照组93例(6.00%),两组比较差异均有统计学意义(P0.05)。母儿预后方面:研究组和对照组产钳助产例数分别为113例(1.65%)和110例(2.04%);产后出血分别为534例(7.81%)和407例(7.56%);绒毛膜羊膜炎例数分别为96例(1.40%)和58例(1.08%);新生儿窒息例数分别为69例(1.01%)和42例(0.78%);新生儿感染性肺炎分别为9例(0.13%)和6例(0.11%),两组以上母儿预后指标比较,差异均无统计学意义(P0.05)。结论新产程应用后剖宫产率降低,主要是活跃期停滞、第二产程延长为指征的剖宫产率降低,孕妇产后并发症及新生儿结局无显著影响。
[Abstract]:Objective to explore the effect of the new and old birth procedure standards on the maternal and infant outcomes. Methods by retrospective analysis, 5 385 pregnant women who were managed according to the old labor standard were set up as control group, and 6 836 pregnant women who were managed according to the new labor standard were set up as the study group to exclude pregnant women, scar uterus, twin pregnancy and placenta previa. Cases of pelvic stenosis, fetal malformation and severe complications of pregnancy have absolute indications of cesarean section. The general data of pregnant women, the causes of cesarean section, the outcome of delivery and the outcome of newborns were compared between the two groups. Results the cesarean section rates in the study group and the control group were 25.19 and 28.79, respectively. The difference was statistically significant (P 0.05), including 742 cases of cesarean section due to active stagnation in the study group and 757 cases of the control group (48.833%), 64 cases of cesarean section in the study group and 93 cases in the control group due to the prolongation of the second stage of labor. The difference between the two groups was statistically significant (P 0.05). Maternal and fetal prognosis: 113 cases (1.65 cases) and 110 cases (2.04%) of parturient forceps in the study group and control group; 534 cases of postpartum hemorrhage (7.81%) and 407 cases of amnionitis (7.56%); 96 cases of chorioamnionitis (96 cases) and 58 cases of 1.0885 cases of neonatal asphyxia. There were 69 cases (1.01%) and 42 cases (0.78%), 9 cases of neonatal infectious pneumonia (0.13) and 6 cases of 0.11% (P < 0.05). The prognosis indexes of more than two groups were compared. The difference was not statistically significant (P 0.05). Conclusion the rate of cesarean section decreased after the application of the new stage of labor, mainly the stagnation of the active period, the rate of cesarean section with the extension of the second stage of labor being decreased, and the postpartum complications of pregnant women and the outcome of the newborn had no significant influence.
【作者单位】：北京大学第三医院妇产科;
【基金】：国家重点研究发展计划(2016YFC1000208-4)
【分类号】：R714

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