无痛分娩下新产程时限管理对母儿结局的临床观察  

Clinical observation on effect of time limit management of new labor process under painless delivery on maternal and fetal outcomes

作　　者：陈志梅[1] CHEN Zhimei(Department of Obstetrics,Shenzhen Maternal and Child Health Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市妇幼保健院产科,广东深圳518000

出　　处：《中国医药科学》2019年第6期15-18,共4页China Medicine And Pharmacy

摘　　要：目的探究无痛分娩下新产程时限管理对母儿结局的临床价值。方法按照随机数字表法将我院2015年6月～2016年6月期间收治的阴道试产单胎足月初产妇108例分为传统组与实验组两组,每组产妇均占54例。传统组产妇采用传统Friedman产程标准,实验组产妇则使用新产程时限管理标准。对比两组产妇的分娩方式(自然分娩、产钳助产、中转剖宫产、会阴侧切)、产程时间、医疗干预情况,并观察两组的产后并发症以及新生儿结局情况。结果两组产妇的分娩方式比较发现存在较大差异,实验组产妇的自然分娩率为81.48%,高于传统组;中转剖宫产率为7.41%,低于传统组,差异有统计学意义(P <0.05);两组产妇的产钳助产率、会阴侧切率比较差异无统计学意义(P> 0.05);两组产妇的第一产程和总产程时间存在较大差异,实验组第一产程时间为(605.36±115.34)min、总产程时间为(670.81±130.50)min,均较传统组更长,差异有统计学意义(P <0.05);两组产妇的第二产程以及第三产程时间比较差异无统计学意义(P> 0.05);两组产妇的医疗干预情况对比存在较大差异,实验组总医疗干预率为27.78%,明显低于传统组,差异有统计学意义(P <0.05);实验组产后出血率、产后尿潴留率、巨大儿以及新生儿窒息率均较传统组高,差异无统计学意义(P> 0.05)。结论产妇在无痛分娩下,采用新产程时限管理产程干预后,尽管第二产程时间延长,但放宽潜伏期的时限,产妇有足够试产时间。有利于降低剖宫产率,改善母儿结局。Objective To explore the clinical value of time limit management of new labor process under painless delivery in maternal and fetal outcomes.Methods According to random number table method,108 full-term primipara with singleton pregnancy who were treated and underwent vaginal trial delivery from June 2015 to June 2016 were divided into the traditional group and the experimental group,with 54 cases in each group.Primipara in the traditional group were given traditional Friedman standard while primipara in the experimental group were given time limit management standard of new labor process.The delivery mode(natural delivery,forceps midwifery,transition to cesarean section,perineal side cut),duration of labor and medical intervention were compared between the two groups.And the postpartum complications and neonatal outcomes were observed.Results There were significant differences in the delivery modes between the two groups.The natural delivery rate of the experimental group was 81.48%,which was higher than that of the traditional group.The rate of transition to cesarean section of the experimental group was 7.41%,which was lower than that of the traditional group.The difference was statistically significant(P<0.05).There was no statistically significant difference in rates of forceps midwifery and perineal side cut between two groups(P>0.05).There were significant differences in the first stage of labor and duration of labor between the two groups.The time for the first stage of labor and duration of labor in the experimental group were respectively(605.36±115.34)min and(670.81±130.50)min,both longer than those in the traditional group.The difference was statistically significant(P<0.05).There was no statistically significant difference in the time for first stage of labor and second stage of labor(P>0.05).There was significant difference in medical intervention between two groups.The total rate of medical intervention in the experimental group was 27.78%,significantly lower than that in the traditional group.Th

关 键 词：无痛分娩 单胎足月初产妇 新产程时限管理产程 母儿结局 

分 类 号：R714.3[医药卫生—妇产科学]