初产妇中转剖宫产发生率及阴道试产失败的相关因素分析:一项多因素Logistic回归分析  

Analysis of the Incidence of Mid-transfer Cesarean Section in Primigravid Women and the Related Factors Affecting the Failure of Vaginal Trial of Labor:A Multifactorial Logistic Regression Analysis

作　　者：陶岚 陈茂林 方艳梅 TAO Lan;CHEN Maolin;FANG Yanmei(Maternity Department,Ma'anshan Maternal and Child Health Hospital,Ma'anshan,Anhui 243000,China)

机构地区：[1]马鞍山市妇幼保健院产科,安徽马鞍山243000

出　　处：《转化医学杂志》2025年第3期1-4,共4页Translational Medicine Journal

基　　金：安徽省高等学校科学研究项目(2220001004351)。

摘　　要：目的探讨初产妇中转剖宫产的发生率及影响阴道试产失败的相关因素。方法选取2023年4月至2024年3月安徽省马鞍山市妇幼保健院产科接受阴道试产的163例初产妇为研究对象,将阴道试产失败后中转剖宫产的初产妇纳入失败组(18例),阴道试产成功的初产妇纳入成功组(145例)。收集2组一般临床资料,将单因素分析中差异有统计学意义的影响因素纳入Logistic回归,分析影响阴道试产失败的相关因素。结果初产妇中转剖宫产的发生率为11.04%;失败组与成功组初产妇在年龄、产前脐动脉收缩期峰值流速/舒张末期流速(UA-S/D)、孕期增重、宫颈成熟度评分(Bishop)方面比较,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,年龄、产前UA-S/D、孕期增重、Bishop评分均为影响阴道试产失败的影响因素。结论初产妇存在中转剖宫产的发生风险,影响阴道试产失败的因素为年龄、孕期增重、宫颈成熟情况等,需引起临床重视,尽早制定相应干预措施,以减少中转剖宫产的发生率。Objective To explore the incidence of mid-transfer cesarean section in primigravid women and the related factors affecting the failure of vaginal trial of labor.Methods A total of 163 primigravid women who underwent vaginal trial of labor in the Department of Obstetrics,Ma'anshan Maternal and Child Health Hospital,Anhui Province,from April 2023 to March 2024 were selected as the study subjects.The primigravid women who were transferred to cesarean section after the failure of vaginal trial of labor were included in the failure group(n=18),and those who succeeded in vaginal trial of labor were included in the success group(n=145).The general clinical data of the two groups were collected,and the influencing factors with statistically significant differences in the univariate analysis were incorporated into logistic regression to analyze the relevant factors affecting the failure of vaginal trial of labor.Results The incidence of mid-transfer cesarean section in primigravid women was 11.04%;compared with the success group,the primigravid women in the failure group had statistically significant differences(P<0.05)in terms of age,antepartum umbilical artery systolic peak flow rate/end diastolic flow rate(UA-S/D),gestational weight gain,and cervical ripening score(Bishop);logistic regression analysis results indicated that age,prenatal UA-S/D,gestational weight gain,and Bishop score were all influencing factors for the failure of vaginal trial of labor.Conclusion Primigravid women are at risk of mid-transfer cesarean section.The factors affecting the failure of vaginal trial of labor include age,gestational weight gain,and cervical ripening,which require clinical attention.Appropriate interventions should be formulated as early as possible to reduce the incidence of mid-transfer cesarean section.

关 键 词：阴道试产 剖宫产 脐动脉收缩期峰值流速/舒张末期流速 初产妇 

分 类 号：R714.4[医药卫生—妇产科学]