Clinical Analysis On Dystocia Factors And Complications Of Intrapartum And Postpartum Of 359 Cases Multipara

Objective: To improve the realization on the delivery and management of multipara by analyzing the factors of multipara dystocia and the occurrence of pathological pregnancy.Method: We selected 359 cases of multipara who were in our hospital between October 2001 to October 2008 as observe group and 359 cases of primipara randomly who were in delivery at the same time as a control group, then analyzed the ways of delivery, pregnancy complications (comorbidities), postpartum complications, and neonatal anomalies of the two groups.Result: 1. Age: the ages of 359 cases multipara were between 24 and 43 years old, the average age of was (34.2±4.07) years old; the ages of 359 cases primipara were between 18 and 41 years old, the average age was (23.2±4.85) years old, there is statistical significance between the ages of the two group(sP <0.05), the age of multipara was significantly older than primipara.2. The characteristics of multipara and antenatal examination:in the cases of 359 multipara ,the proportion of multipara whom come from other cities was 85.79% (308/359), ,the proportion of multipara whom come from country was 79.94% (287/359), multipara who had no antenatal examination at all accounted for 27.02% (97/359), multipara had regular antenatal examination accounted for 15.04% (54/359), while the multipara whom had done antenatal examinations several times but not systemly accounting for 57.94% (208/359). 3. Delivery manner: the cesarean section rate in multipara was 69.92% while in primipara was 74.65%,there is no statistical significance in the difference of delivery manner of two groups. 4. The incidence rate of breech dystocia and uterine atony in multiparas was significantly higher than primipara. (P <0.05). 5.The incidence rate of hypertensive disease of pregnancy in multipara was significantly higher than in primipara. (χ~2 = 35.0315, P <0.001),the incidence rate of pregnancy associated with diabetes in multipara was significantly higher than in primipara (χ~2 = 6.2075, P <0.05), the incidence rate of placenta previa in multipara was significantly higher than in primipara(χ~2 = 0.0010, P <0.01). 6. Newborns anomalies: the incidence rate of low birth weight infants from multipara was significantly higher than primipara. (χ~2 = 22.6832, P <0.0001), the incidence rate of macrosomia from multipara was significantly higher than primipara (χ~2 = 5.4350, P <0.05).Conclusion:1.The age of multipara was significantly older than primipara.2.The proportion of multipara was increased whose last delivery had past more than 10 years.3.Antenatal examination of multipara is not ideal, we should pay attention to its great importance and do much better.4.The dystocia in multipara has the same chance with primipara, there is no significantly different between the them.5.The incidence rate of breech dystocia and uterine atony in multiparas was significantly higher than primipara.6.The proportion of cesarean section in multipara has no significant different than in primipara.7.The incidence rate of hypertensive disease of pregnancy in multipara was significantly higher than in primipara.8.The incidence rate of pregnancy associated with diabetes in multipara was significantly higher than in primipara.9.The incidence rate of placenta previa in multipara was significantly higher than in primipara.10.The incidence rate of low birth weight infants and macrosomia from multipara ware significantly higher than form primipara.