| Objective: Discussion the clinical application value on new labor time limit standard and old labor time limit standard.Methods: This was a retrospective study based on the partogram of 263 maternal of laboring, term, singleton,vaginal trial production from October 1 to December 31,2014 in the first Affiliated Hospital of Fujian Medical University, and the clinical data were collected.Matrenal in accordance with the Friedman standard is divided into control group a total of 181 case,according to the new labor limit standard is divided into the observation group a total of 82 case, compared two groups of the labor process characteristics and outcomes of maternal and neonatal.Compared to the outcome of pregnancy on the same period in 2013, October to December, a total of 721 cases of delivery in our hospital, and to explore the importance of clinical observation if advocated the new labor limit standard.Results:1. 181 cases in the control group, including 143 cases of vaginal delivery(79%),emergency cesarean section in 38 cases(21%). The observation group of 82 cases, including65 cases of vaginal delivery(79.27%), emergency cesarean section in17 cases(20.73%).Age, gestational age, birth weight of newborn of the two groups had not statistical significance.2.Statistics of two groups of gestational diabetes mellitus, pregnancy with uterine myoma,polyhydramnios and premature rupture of membranes was not significantly difference(P > 0.05).3.The observation group and the control group in cesarean section or vaginal were no adverse on maternal outcomes.The meconium-staindamniotic fluid, postpartum hemorrhage, perineal incision infection rate had no significant difference in two groups(P>0.05).Comparison of two groups the rate of cesarean section and forceps delivery,there was no significant difference(P>0.05).Fetal distress, neonatal asphyxia and therate of neonatal into NICU in the observation group had no significant difference from the control group(P>0.05).4. If according to the standards of the old labor time limit women in the observation group shall be line splits the palace production, then the study among 263 cases of pregnant women who should by cesarean section were a total of 120 cases(38+ 82 cases), accounting for 45.63%; however, the observation group in accordance with the new labor time limit standard for observation process, this study among 263 cases of maternal were a total of 55 cases(38 cases of 17 cases) taking caesarean operation actually, accounting for 20.91%, the two cases of cesarean section rate P value was significant(P < 0.05).While the difference of the latency extention, the prolonged second stage, fetal distress and relative pelvic disproportion is no significant(P > 0.05).5.According to Friedman labor limit standard,the abnormal labor duration rate in control group 18 cases accounted for 47.36% in active period, 4 case occurred 10.52%in the second stage of labor,1case occurred 2.63%in latent period;according to the new standard labor time, the observation group active period duration abnormal 3cases accounted for 17.65%, the second stage duration abnormal 4 cases accounted for23.53%, the latency time duration abnormal with no case was 0%.6. The first stage of the observation group the average duration of active period was shorter than that of the control group(2.69+1.91 hours between 3.08+1.65 hours,P<0.05, 95% confidence interval 2.28-3.25 hours).According to the new labor limit standard to extend the observation time, the first stage of the observation group average duration is statistically significantly increased(12.87- 4 hours with a control group of7.26 + 3.03 h, P<0.05, 95% confidence interval 11.75-13.85); there was significant both in the second stage of labor in observation group compared to the average time, average duration was longer than that of the control group(difference 1.17- 1 hours compared with the control group of 0.59- 0.44 hours, P < 0.05; 95% confidence interval 0.95-1.43hours).7.Compared the cesarean section rate, postpartum hemorrhage rate, the infectious rate of perineal, fetal intrauterine distress, rate of neonatal to NICU from 2014 Octoberto December a total of 769 case with 2013 October to December a total of 721 case in our hospital, found that the rate of cesarean section and fetal intrauterine distress had significant difference(P<0.05), the other no significant difference(P>0.05), the rate of2014 cesarean section was significantly decreased.Conclusion:1. The new labor time limit standard makes the splits the palace to produce the technique of maternal full trial opportunities,avoiding unnecessary cesarean section,so the rate of cesarean section reducing. Although with the new labor time limit the total of production time is extended, there were no significant differences between the two groups of maternal and neonatal outcome. The new labor time limit is more conducive to the delivery of management, to take appropriate measures in time to achieve a more effective delivery, reduce the rate of cesarean section.2. Analysis the labor time limit of the observation group and the control group,the anormal labor course mostly occurred in the active period and the second stage of labor, the latency period last, we thought whether relax latency time and the end of incubation period can reduce unnecessary intervention.3.To observe the labor process requires a combination of cervical dilatation and fetal descent. If premising to advocate the new partogram, the intervention measures will change, the most impotance is the early detection of cephalopelvic disproportion,the fetal monitoring closely and paying attention to maternal mood. |
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