Starting Point Of Active Phase Of Labor,Labor Duration And Perinatal Outcome Analysis Of Preterm Primipara And Full Term Primipara

ObjectiveTo describe the distribution of the starting point of active phase of labor of preterm primipara and full term primipara,comparative analysis related indicators of labor duration and perinatal outcomes,explore whether to adopt the same method for labor monitoring,provide the basis for the correct treatment in clinical practice.MethodsSelect January 2013-December 2016 in Tianjin central hospital of gynecology obstetrics obstetric ward childbirth meet the inclusion criteria of preterm primipara（gestational age 28w-36+6 w）925 cases,at the same time,836 cases of term full-term primipara（37w-41+6w）were selected randomly from September to December in 2016,the cervical dilatation curves from the turning point of the gentle turning angle to the corresponding cervical dilatation as the starting point of the active phase,record the active phase of each maternal starting point,active phase and the average rate of uterine cervix expansion,and record the general information and perinatal outcome.Using SPSS20.0 statistical software,the measurement data of normal distribution are expressed in the form of X±S,and the data are compared by t-test or F-test;the measurement data of non-normal distribution are expressed in the form of M（P5,P95）,and the data are compared by non-parametric test;count data using the example and the percentage（%）of the form,the data comparison using theχ2 test,P<0.05 shows the difference has statistical significane.Results1.The distribution of the initial phase of the preterm delivery of active maternity women:1cm 25 cases（2.70%）,2cm 275 cases（29.73%）,3cm 258 cases（27.89%）,4cm 203 cases（21.95%）,5cm 109 cases（11.78%）,≥6cm 55 cases（5.95%）,60.32%of preterm delivery women in the cervix expansion≤3cm into active period,82.27%of preterm delivery women in the cervix expansion≤4cm into active period,94.05%of preterm delivery women in the cervix expansion≤5cm into active Period;the starting point of the active term of the full-term early-term maternal distribution:2cm 67 cases（8.01%）,3cm 188 cases（22.49%）,4cm 260 cases（31.10%）,5cm 152cases（18.8%）,6cm 115 cases（13.76%）,7cm 25 Cases（2.99%）,8cm 29 cases（3.47%）,61.60%of full-term early-born women in the uterine distention≤4cm into the active period,79.78%of full-term early-term women in the uterine distention≤5cm into the active period,93.54%of full-term early-born women in The uterine distention≤6cm enters the active period,and the starting point of the active period of the preterm labor is earlier than that of the early-term maternal.2.Compared with full-term primipara,preterm primipara’s duration of the first stage of labor,the second stage of labor,the third stage of labor,the active phase,the average rate of active phase cervical expansion was statistically significant（P<0.05）.The duration of the first stage of labor,the duration of the second stage of labor and the period of active phase of preterm primipara are significantly lower than those of term full-term,while the the third stage of labor and the average rate of active phase cervical expansion is obviously higher than that of the full-term stage.3.The gestational weeks less than 34 weeks of primipara was divided into three groups according to different gestational age,pregnant 28-29⁺66 weeks 50 cases,pregnant 30-31⁺⁶ weeks 61 cases pregnant 32-33⁺⁶ weeks 151 cases,three groups of the first stage of labor,the second stage of labor compared with the time difference was statistically significant（P<0.05）.As gestational age increases,the first stage of labor,the second stage of labor increased.4.Preterm primipara was divided into two groups according to the presence or absence of premature rupture of membranes,589 cases of PPROM group,336 cases of non-PPROM group,the first stage of labor,the second stage of labor,the active phase,the average rate of active phase cervical expansion was statistically significant（P<0.05）.The PPROM group of the first stage of labor,the active phase is lower than the non-PPROM group,and the average rate of active phase cervix dilatation is higher than the non-PPROM group.5.According to the different starting point of the active phase grouping,there was a significant difference in the first stage of labor between preterm and full-term primipara groups（P<0.05）.As the starting point of the active phase of the delay,premature primipara and full-term primipara first-stage prolongation of labor.6.Compared with full-term primipara,preterm primiparae showed statistically significant differences in the amount of hemorrhage and lateral excision（P<0.05）.Preterm group’s hemorrhage and lateral delivery rate were lower than the full-term group.7.Preterm birth and full-term newborns,1minApgar score,5minApgar scores were statistically significant（P<0.05）.Preterm birth of newborns 1minApgar score,5minApgar scores were lower than the full-term newborn.Conclusions1.61.60%of full-term primiparae enter active phase of labor before the cervix expansion to 4cm,93.54%of full-term primiparae enter active phase of labor before the cervix expansion to 6cm,therefore,it is reasonable to use 6cm as the starting point of the active phase of labor.2.The duration of labor and active phase of labor of preterm labor primipara is shorter than that of full-term primipara,and the standard of labor process of full-term primipara should not be applied to preterm labor.3.Premature labor,the smaller the gestational age,shorter duration of labor,prenatal care should be closely monitored gestational smaller pregnant women progress.4.Premature rupture of membranes may be one of the factors influencing the time of labor in premature labor and the progress of labor in PPROM pregnant women should be closely monitored.