Factors affecting failed trial of labor and countermeasures:A retrospective analysis  

作　　者：Jin-Guang Wang Jing-Li Sun Jian Shen 

机构地区：[1]Department of Obstetrics and Gynecology,General Hospital of Northern Theater Command(Heping Campus),Shenyang 110000,Liaoning Province,China

出　　处：《World Journal of Clinical Cases》2020年第16期3483-3492,共10页世界临床病例杂志

基　　金：Supported by Liaoning Provincial Natural Science Foundation Guidance Program,No.2019-ZD-1037。

摘　　要：BACKGROUND Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy.However,the cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet in 2010.AIM To retrospectively analyze the factors related to failed trial of labor and the clinical indications for cesarean section conversion,explore how to promote the trial of labor success rate,and determine the feasibility of reducing the rate of conversion to cesarean section.METHODS A retrospective analysis was performed on 9240 maternal women who met vaginal delivery conditions and required a trial of labor from January 2016 to December 2018 at our hospital.Among them,8164 pregnant women who had a successful trial of labor were used as a control group,and 1076 pregnant women who had a failed trial of labor and converted to an emergency cesarean section were used as an observation group.The patients’clinical data during hospitalization were collected for comparative analysis,the related factors of the failed trial of labor were discussed,and reasonable prevention and resolution strategies were proposed to increase the success rate of trial of labor.RESULTS The analysis revealed that advanced age(≥35 years old),macrosomia(≥4000 g),delayed pregnancy(≥41 wk),use of uterine contraction drugs,primipara,and fever during labor were associated with conversion to an emergency cesarean section in the failed trial of labor.Multivariate regression analysis showed that age,gestational age,primipara,use of uterine contraction drugs,fever duringbirth,and newborn weight led to a higher probability of conversion to an emergency cesarean section in the failed trial of labor.The analysis indicated that the following clinical indications were associated with the conversion to cesarean section in the failed trial of labor:Fetal distress(44.3%),social factors(12.8%),malpresentation(face presentation,persistent occipitoposterior position,and persistent occipitotransverse position)(9.4%),and cephalopelvic d

关 键 词：Trial of labor Vaginal delivery Cesarean section DYSTOCIA Retrospective analysis 

分 类 号：R719.8[医药卫生—妇产科学]