Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (02): 180 -185. doi: 10.3877/cma.j.issn.1673-5250.2019.02.009

Special Issue:

Original Article

Effects of new standard of labor stage on perinatal outcomes of low-risk puerperae

Hongyu Li1, Qing Chang1, Chunming Zheng1, Dan Wang1,()   

  1. 1. Department of Obstetrics and Gynecology, First Affiliated Hospital of Army Medical University, Chongqing 400038, China
  • Received:2018-09-18 Revised:2019-01-04 Published:2019-04-01
  • Corresponding author: Dan Wang
  • About author:
    Corresponding author: Wang Dan, Email:
  • Supported by:
    Project of Chongqing Association for Science and Technology(2017jstg24)
Objective

To investigate the effects of the implementation of Expert Consensus on the New Standard and Treatment of Labor Stage new standard of labor stage on perinatal outcomes in low-risk puerperae.

Methods

A total of 2 066 low-risk puerperae who were hospitalized in the Department of Obstetrics of First Affiliated Hospital of Army Military Medical University from July 1, 2015 to June 30, 2016 and were managed by new standard of labor stage, were selected and included into study group. Meanwhile, another 2 108 low-risk puerperae who were managed by old standard of labor stage in the same hospital from July 1, 2014 to June 30, 2015 were selected and included into control group. The following items were retrospectively analyzed and compared, general clinical data (age, height, weight, gestational age), modes of delivery (intrapartum cesarean section, forceps delivery, vaginal delivery), composition ratio of indications for intrapartum cesarean section, incidence of postpartum hemorrhage of parturient, Apgar score and birth weight and incidence of neonatal asphyxia of newborns. The general clinical data(age, height, weight, gestational age), newborn birth weight and Apgar score of newborns between two groups were statistically analyzed by independent-samples t test. The amount of postpartum hemorrhage were statistically analyzed by Mann-Whitney U rank sum test. The incidence of intrapartum cesarean section, forceps delivery and vaginal delivery were statistically analyzed by chi-square test. The procedures followed in this study were in accordance with the ethical standards established by the Human Subjects Trial Committee of First Affiliated Hospital of Army Medical University, and this study was approved by this committee [Approval No. 2014(102)]. Informed consent was obtained from each individual participant included in the study.

Results

①There were no significant differences between two groups in the general clinical data and birth weight of newborns (P>0.05). ②The intrapartum cesarean section rate and forceps delivery rate in study group were 27.4% (566/2 066) and 2.4% (50/2 066) respectively, which were significantly higher than those of control group 36.7% (774/2 108) and 8.1% (171/2 108), while the vaginal delivery rate of study group was 70.2% (1 450/2 066), which was significantly lower than that of control group 55.2% (1 163/2 108), and the differences were statistically significant (χ2=41.592, 67.412, 100.451; all P<0.001). ③ For the indications of intrapartum cesarean section, the incidences of abnormal labor duration (extended labor incubation period, stagnation of active period, extended second stage of labor) of study group were significantly lower than these of control group (χ2=73.925, 69.443, 35.734; all P<0.001). While the incidence of fetal distress in study group was 46.6%(264/566), which was higher than that of 20.7% (160/774) in control group, and the difference was statistically significant (χ2=101.950, P<0.001). ④Moreover, there were no significant differences between two groups in the amount of postpartum hemorrhage and the incidence of postpartum hemorrhage (P>0.05). ⑤ There were no significant differences between two groups in Apgar score of 1 min and 5 min after birth and incidence of neonatal asphyxia (P>0.05).

Conclusions

New standard of laber stage can reduce the incidence of intrapartum cesarean section and forceps delivery, promote vaginal delivery in low-risk puerperae, and it will not increase the risk of adverse perinatal outcomes. New standard of labor stage is worthy of clinical application.

表1 2组低危产妇的一般临床资料及新生儿出生体重比较(±s)
表2 2组低危产妇的分娩方式构成比比较[例数(%)]
表3 2组低危产妇经阴道试产失败转剖宫产术分娩指征构成比比较[例数(%)]
表4 2组低危产妇的产后出血量和产后出血发生率比较
表5 2组低危产妇分娩新生儿生后1、5 min Apgar评分及窒息发生率比较
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