首次妊娠阴道试产转剖宫产影响因素及预测价值  

Influencing factors and it's predictive value of the first time of the vaginal trial failure of pregnant women

作　　者：赵言 邱迎军 卫家铭 ZHAO Yan;QIU Yingjun;WEI Jiaming(Yuncheng Central Hospital of Shanxi province,Yuncheng,Shanxi Province,044000)

机构地区：[1]山西省运城市中心医院,044000

出　　处：《中国计划生育学杂志》2024年第11期2678-2682,共5页Chinese Journal of Family Planning

摘　　要：目的:探究首次妊娠中转剖宫产影响因素及其预测价值。方法:回顾性收集2021年1月-2024年1月本院行阴道试产的首次、足月、单胎妊娠产妇1650例临床资料,其中转剖宫产200例为剖宫产组,余产妇按照1:1比例随机抽取阴道试产成功者200例为阴道分娩组。对比分析两组相关资料,单因素及多因素logistic回归分析影响中转剖宫产的相关因素;受试者工作特征(ROC)曲线分析独立因素构建的风险预测模型对中转剖宫产的价值。结果:1650例阴道试产产妇中转剖宫产200例,占比12.1%,其中因相对头盆不称中转剖宫产所占比例最大(69.0%)。剖宫产组产妇年龄、产前体质指数(BMI)、胎膜早破比例、羊水分度、引产比例、新生儿体重及身长均大于阴道分娩组,宫颈Bishop评分小于阴道分娩组(P<0.05)。logistic回归分析,Bishop评分高是降低中转剖宫产率的相关因素,而产妇年龄大、产前BMI高、新生儿体重大是中转剖宫产的危险因素(均P<0.05)。基于独立因素的风险模型预测中转剖宫产的曲线下面积为0.821(95%CI 0.780~0.857),敏感度77.0%,特异度74.5%。结论:产妇年龄大、产前BMI高、宫颈成熟度低及新生儿体重大会影响阴道试产中转剖宫产,基于上述因素构建的风险预测模型对首次妊娠中转剖宫产有一定的预测价值,可指导临床分娩干预。Objective:To explore the status quo and the influencing factors of the cesarean section of women with the first pregnancy,and to establish the prediction model for the cesarean section of the women.Methods:The clinical data of 1650 full-term women with the first pregnancy and the singleton who had undergone the vaginal trial labor from January 2021 to January 2024 were collected retrospectively.Among them,200 women in study group were transferred to the cesarean section,and in the other 200women with the successful vaginal delivery were randomly selected in control group.The related data of the women were analyzed and compared between the two groups.Univariate and multivariate logistic regression analysis were used to analyze the related factors affecting the transfer to the cesarean section of the women.Receiver operating characteristic(ROC)curve was used to analyze the value of the risk prediction model constructed based on these independent influencing factors of the women for their transfer to the cesarean section.Results:Among the 1650women with the vaginal trial labor,there were 200(12.1%)cases with the transferred to the cesarean section.In the study group,the proportion of the transferred to the cesarean section of the women due to the relative cephalopelinal disproportion was 69.0%,and which was the highest.The maternal age,the prenatal body mass index(BMI),the proportion of the premature rupture of membranes,the classification of the amniotic fluid,the proportion of the induced labor and the neonatal weight and length of the women in the study group were significantly higher than those of the women in the control group,and the cervical Bishop score of the women in the study group was significantly lower than that of the women in the control group(P<0.05).Logistic regression analysis showed that the higher Bishop score of the women was a related factor to reduce their transferred to the cesarean section,while the advanced age,the higher prepregnant BMI,and the higher neonatal weight of the women were the

关 键 词：初产妇 阴道试产 中转剖宫产 影响因素 预测价值 

分 类 号：R719.8[医药卫生—妇产科学]