Analysis Of Labor Augmentation And The Pregnancy Outcome When The Onset Of Active Phrase Of Labor Varies

Objective:Discussion on the optimal time of labor augmentation under the introduce of the new labor time limit standard.Methods:We retrospectively collected the partogram and clinical information of 660 term,singleton,vertex fetus nulliparous which deliveried in the Maternal and Child Care Service Center of Fujian Province from January 1st to March 3rd 2015.Taking the onset point depicted on the partogram as the onset of active phrase of labor and divided them into groups of 3cm,4cm,5cm and 6cm or more based on it. Comparing the difference of labor augmentation and maternal and neonatal outcome in these group and also the rate of labor arrest,cesarean,induced labor, the use of oxytocin and the progression of labor.1?There are 427 nulliparous in the group of cervical dilation of 3cm,including 374 ones of vaginal delivery,10 ones delivered by forceps and 43 ones by cesarean. There are 37 nulliparous in the group of cervical dilation of 4cm, 35 of them delivery vaginally,one delivered by forceps and 2 ones by cesarean.There are 61 and 135 nulliparous in the group of cervical dilation of 5cm and more than 6cm.Both of them delivery vaginally.The age,BMI before pregnancy and gestation between different groups show no significance. 2?The duration of active phase of labor and first stage of labor in the group of cervical dilation of 3cm show statistical significance comparing with other groups.The group of cervical dilation of 3cm show statistical significance comparing with more than 6 cm group in the duration of second stage of labor and newborn weight. 3?There are 104 labor arrest happened in the group of cervical dilation of 3cm,including 70 of them delivery vaginally and 34 of them by cesarean.Among the labor arrest,90 of them happened once and 14 of them happened twice.There are 1 labor arrest happened in the group of cervical dilation of 4cm which delivery by cesarean.There was no labor arrest happened in the group of cervical dilation of 5cm and more than 6cm. 4?The maternal age, BMI before delivery and dose of oxytocin for induction is the risk factors of cesarean. 5?The maternal and neonatal outcomes including post hemorrhage,acute chorioamnionitis,cephalhematoma of newborn,admission of NICU showed no statistical significance. Result:Conclusion: 1?Promoting the onset of active phrase of labor and labor observation duration. Offering enough time for delivers can reduce the cesarean rate in a certain degree. 2?The second stage of labor more than 1 hour can still delivery vaginally.Extent the observation time properly can reduce the rate of vaginal assisted delivery. 3?The maternal age,BMI before delivery and dose of oxytocin for induction is the risk factors of cesarean.4?Taking care of the occurrence of persist occiputal posterior position and persist occiputal tranverse position in labor,promping the guidence of maternal position and manual fetal head rotation in order to reduce the cesarean rate.