采用产程新标准后产钳助产相关影响因素及对母儿结局影响研究

发布时间：2018-11-01 15:22

【摘要】：目的探讨采用产程新标准后产钳助产相关影响因素,并分析产钳助产后对母儿结局的影响。方法选择2010年1月至2015年8月在重庆医科大学附属第一医院因第二产程延长行产钳助产的产妇142例,观察组采用产程新标准(2013年8月后)共32例,对照组采用产程旧标准(2010年1月至2013年7月)共110例。对产钳助产前临床资料、产钳助产发生率及围产结局进行分析;采用巢式病例对照研究和条件Logistic回归分析产钳助产的相关影响因素。结果采用新产程标准后因第二产程延长产钳助产的发生率显著下降(0.56%vs.1.81%,P0.05)。产程标准是产钳助产的独立保护因素(B值-1.420,OR 0.242,95%CI 0.131~0.445),而入院BMI值(B值0.492,OR 1.635,95%CI 1.083~2.469)和羊水粪染(B值0.312,OR 1.367,95%CI 1.091~1.711)是独立危险因素,均与产钳助产密切相关(P0.05)。观察组产妇宫颈裂伤患病率显著低于对照组,而新生儿1 min Apgar评分显著高于对照组(P0.05)。结论产程新标准与产钳助产发生率降低有关,新旧产程标准产钳助产母儿结局无广泛影响。
[Abstract]:Objective to explore the related factors of forceps delivery and to analyze the effect of forceps delivery on maternal and fetal outcomes. Methods from January 2010 to August 2015, 142 cases of parturient in the first affiliated Hospital of Chongqing Medical University who were given delivery with forceps due to the extension of the second stage of labor were selected. The observation group adopted the new standard of labor process (after August 2013) in a total of 32 cases. In the control group, 110 cases were treated with the old standard of labor process (January 2010 to July 2013). The clinical data before forceps delivery, the incidence of forceps delivery and perinatal outcome were analyzed, and the related factors of forceps delivery were analyzed by nested case-control study and conditional Logistic regression analysis. Results after the adoption of the new labor standard, the incidence of delivery by forceps was significantly decreased after the extension of the second stage of labor (0.56 vs 1.81 P 0.05). The standard of labor process was the independent protective factor of forceps delivery (B value -1.420 / OR 0.242 / 95 CI 0.131 / 0.445), while the admission BMI value (B value 0.492OR 1.63595 / CI 1.083 / 2.469) and amniotic fluid feces staining (B = 0.312), respectively. OR 1.367 ~ 95 CI 1.091 ~ 1.711) was an independent risk factor, which was closely related to forceps delivery (P0.05). The incidence of cervical laceration in the observation group was significantly lower than that in the control group, while the neonatal 1 min Apgar score was significantly higher than that in the control group (P0.05). Conclusion the new standard of labor process is related to the decrease of the incidence of forceps delivery, but the new and old standard forceps have no extensive influence on the outcome of mothers and infants.
【作者单位】：重庆医科大学附属第一医院妇产科;重庆医科大学附属第一医院医保办;
【基金】：国家临床重点专科建设经费资助项目(201101ck ZD)
【分类号】：R717

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