Analysis Of 100 Cases Of The New And Old Labor Standards Influence On Delivery

Object:To investigate the influence of the old and new labor standards on delivery. comparison of old and new labor management application at the beginning of the birth process delivery progress and mode of delivery, and the relationship with prognosis of maternal, newborn.Method:Data were from the Dalian Central Hospital, a retrospective cohort study that abstracted detailed labor and delivery information from electronic medical records from June 2014 to February 2015.there are many nulliparous women were selected who had a singleton term gestation, vertex presentation, the gestational weeks bettween 37 and 42, spontaneous onset of labor, and without epidural anesthesia for painless labor. According to the old labor standards of abnormal as the selected condition and the application of new and old labor standards, there were a total of 100 deliveries in the database. According to the old or the new use of labor standards, there is divided into two groups:the new labor group and the old labor group,50 cases in each.Result:The mean age of the patients with the new and the old labor group was 28.1 years old and 28.5 years old, respectively. The average gestational age of the maternal patients with the new and the old stage of labor group was 39.6 weeks and 39.8 weeks, respectively. The mean birth weight of the patients with the new and the old labor group was 3491 gram and 3574 gram, respectively. The average BMI at the end of pregnancy with the new and the old labor group was 28.48kg/m2,28.07kg/m2. And both of them were more than 25 which means overweight. The patients of the new labor group with pregnancy associated diseases was performed on 11 cases (22%), the old labor group 12 cases (24%). Both the new and the old labor group were 5 (10%) cases of premature rupture of membranes. The rates of artificial rupture of membranes in new and old babor group was respectively 50% and 56% which were high proportions. The mean amount of bleeding with the new and the old labor group was 251ml and 252ml, respectively. The patients of the new (or the old) labor group with the Ⅰ, Ⅱ and Ⅲ degree of intrapartum meconium stained amniotic fluid were 1 (0) cases,6 (6) cases,1(1) cases, respectively. Nevertheless, the number of cases of the new labor group with neonatal asphyxia was performed on 4 cases (8%), the old labor group 3 cases (6%). The patients, among them, were mild asphyxia of newborn asphyxia. However, age, height, gestational weeks, BMI before/late pregnancy, with(or without) complications of pregnancy, the way of rupture of membranes, the numbers of cord around neck, neonatal birth weight, amount of bleeding, PH, SBE, lateral episiotomy, manual removal of placenta, manual rotation of the fetal occiput, vacuum assisted operative vaginal delivery, the level of meconium stained amniotic fluid, postpartum hemorrhage, infection of incision, chorioamnionitis, neonatal asphyxia and the degree of perineal laceration are no significant difference between the new and the old labor group statistically (P>0.05). The patients of the new labor group in oxytocin application was performed on 19 cases (account for 38%), the old labor group 29 cases (account for 58%); and there was no difference between the two groups statistically (by X2 square test, P<0.05), which means the application of the new production process management to reduce the use of oxytocin. Furthermore, the medians (and 95th percentile) of duration of latent phase of labor in the new and old labor group was 20.5h (27.21 h),15.45h (20.43 h),r espectively. We found, in the new labor group,that the median (and 95th percentile) times of cervical dilatation progressing from 0cm to 3cm was 16.5 (20.82)h. The 95th percentile of the 2nd stage of labor in the new labor group was 160.7min, more than 2 hours, which is not associated with poor maternal and neonatal outcome. Compared with the old labor group, the cesarean delivery rate of the new labor group was reduced by 10% which was equivalent with 5 cases. Among them, a prolonged latent phase, the indication of cesarean delivery, was 3 cases (6%) in the old labor group, and a arrested descent 2 cases (4%). But the mode of delivery and the indication of cesarean delivery did not differ significantly in the two groups (by X 2 square test, P> 0.05). Finally, there is no obvious slowdown phenomenon of cervical dilatation in the late active phase (dilatation of cervix from 9cm to 10cm).Conclusion:(1) For nulliparous women, the application of the new production process managed to reduce the use of oxytocin. (2) It was not increasing the risk of obstetric interventions, maternal and neonatal complications that revising of the starting point of active period and the second stage of labor duration in the new labor standards. (3) The rates of cesarean section is reduced by the application of new labor process. Thereinto, the indications of abnormal labor for cesarean delivery reduced significantly.