西北某三甲医院足月初产妇阴道试产失败率调查及影响因素分析  

Investigation on the failure rate and influencing factors of vaginal trial delivery in full-term primipara at a tertiary hospital in Northwest China

作　　者：黎姗 张方方 LI Shan;ZHANG Fangfang(Gynecology and Obstetrics Department,Xi'an Fourth Hospital/Xi'an People's Hospital,Xi'an 710004,China)

机构地区：[1]西安市第四医院/西安市人民医院妇产科,陕西西安710004

出　　处：《临床医学研究与实践》2024年第32期27-30,共4页Clinical Research and Practice

摘　　要：目的调查西北某三甲医院足月初产妇阴道试产失败情况并分析其影响因素。方法回顾性分析2022年5月至12月在西北某三甲医院定期产检且首选为阴道试产分娩的924例单胎足月初产妇的临床资料,统计其阴道试产结局,并采用多因素Logistic回归分析探讨影响初产妇阴道试产失败的因素。结果924例初产妇阴道试产失败率为7.79%,失败原因以胎儿窘迫为主(44.44%),其次为第二产程停滞(18.06%)、活跃期停滞(13.89%)。阴道试产失败产妇的高龄、孕期体重增加过多、分娩前超重/肥胖、分娩前焦虑、男胎占比均显著高于试产成功产妇,家庭人均月入≥5000元、导乐陪伴、分娩镇痛占比以及身高显著低于试产成功产妇,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,高龄、分娩前焦虑、男胎是影响初产妇阴道试产失败的危险因素,家庭人均月收入≥5000元、身高≥158.0 cm、导乐陪伴是阴道试产失败的保护因素(P<0.05)。结论符合阴道试产指征的足月初产妇仍存在一定的阴道试产失败风险,高龄、家庭人均月收入、身高、分娩前焦虑、导乐陪伴、男胎均是影响初产妇阴道试产成功与否的重要因素。Objective To investigate the failure of vaginal trial delivery of full-term primipara at a tertiary hospital in Northwest China and analyze its influencing factors.Methods The clinical data of 924 full-term primiparas with singleton pregnancy who underwent regular prenatal examination and preferred vaginal trial delivery at a tertiary hospital in Northwest China from May to December 2022 were retrospectively analyzed.The outcome of vaginal trial delivery was counted,and the influencing factors of failed vaginal trial delivery in primiparas were analyzed by Logistic regression analysis.Results The failure rate of vaginal trial delivery in 924 primiparas was 7.79%.The main cause of failure was fetal distress(44.44%),followed by stagnation of the second stage of labor(18.06%)and stagnation of active phase(13.89%).The proportion of advanced age,excessive weight gain during pregnancy,overweight/obesity before delivery,anxiety before delivery and male fetus of women with failed vaginal trial delivery were significantly higher than those of women with successful vaginal trial delivery,and the proportion of family per capita monthly income≥5000 yuan,doula accompany,labor analgesia and height were significantly lower than those of women with successful vaginal trial delivery,the differences were statistically significant(P<0.05).Logistic regression analysis showed that advanced age,anxiety before delivery and male fetus were risk factors for the failed vaginal trial delivery in primiparas,and family per capita monthly income≥5000 yuan,height≥158.0 cm and doula accompany were protective factors for the failed vaginal trial delivery(P<0.05).Conclusion There is still a certain risk of failure of vaginal trial delivery in full-term primiparas who meet the indications of vaginal trial delivery.Advanced age,family per capita monthly income,height,anxiety before delivery,doula accompany and male fetus are all important factors affecting the success of vaginal trial delivery in primiparas.

关 键 词：阴道试产 足月 初产妇 

分 类 号：R714.4[医药卫生—妇产科学]