Analysis Of 510 Cases Of Vaginal Delivery In Maternal With Singleton Cephalic Presentation At Term

Objective:To explore the characteristics of labor and maternal-neonatal outcomes under the guidance of new labor standard,in order to improve the natural delivery rate and maternal-neonatal outcomes,reduce cesarean section rate.Methods:This is a retrospective analysis of 510 cases of who intended to vaginal delivery in the First Affiliated Hospital of Kunming Medical University from August 15,2016 to October 31,2016.The basic datas and delivery informations were collected to observe the characteristics of labor and Maternal and Fetal outcomes.The data analysis uses SPSS 23.0 statistical software.The measurement data is expressed by x±s and uses t testing and variance analysis for comparison.The enumeration data uses frequency and percentage,the comparison between the groups usingtesting.P<0.05 means the difference is statistically significant.Results:1.There were 357 cases of primiparas in the total 510 cases,including 336 cases of vaginal delivery,40 cases of forceps delivery,21 cases of cesarean section,153 cases of multiparas,including 152 cases of vaginal delivery,4 cases of forceps delivery,1 case of cesarean section.The main indications for the forceps is poor fetal heart rate tracing,the main indications for cesarean section is cephalopelvic disproportion.With the increasing of the birth weight of neonates,the cesarean section rate was increased due to the cephalopelvic disproportion,but there was no significant difference between the two groups(P>0.05).2.There was no significant difference between the length of labor and the birth weight of newborns(P>0.05).The rate of natural labor was lower in the other complications group than in the non-pregnancy complication group(P<0.05).The rate of cesarean section was higher than that of non-pregnancy complication group(P<0.05).There was no statistically significant difference in the mode of delivery between the other groups(P>0.05).There was no significant difference in maternal outcome between the groups(P>0.05).There was no significant difference in the incidence of Apgar score ?7,the neonatal check-in pediatric rate and giant children rate(P>0.05),but significant difference in neonatal pediatric pediatric(P<0.05).3.According to the LDT group,the multipara was significantly shorter than the primipara in the duration of labor(P<0.01)and no significant difference in the duration of labor between the multipara groups(P>0.05);The longer the interval time between this pregnancy and the last,the longer of the labor time.;There was significant difference between neonatal birth weight and multipara in LDT3 to 6 years(P<0.01)and no significant difference in neonatal birth weight between the other groups(P>0.05).4.The second stage of labor longer than 2 hours of maternal,episiotomy rate was.higher than the second stage of labor shorter than 2 hours(P<0.01).The second stage of labor in the length of 2.5 to 3 hours of matemal,the forceps and postpartum hemorrhage rate were higher than the second stage of labor shorter than 2 hours of matemal(P<0.05);There were no statistically significant differences in the incidence of severe perineal laceration,neonatal check-in pediatric and the incidence of Apgar score ?7 between the second stage of labor longer than 2 hours of maternal and the second stage of labor shorter than 2 hours(P>0.05).5.There are individual differences at the starting point of the active period.Most of the starting point of active stage of the primipara and multipara are located in the cervix dilatation from 3 cm to 6cm,some are after 6cm.When the primiparas'cervix were expanded 3cm,4cm,5cm,6cm respectively,then the percentage into the active period is 24.4%,41.4%,65.8%,91.4%respectively;At multipara,when cervix were expanded 3cm,4cm,5cm,6cm,then the percentage into the active period is 30.3%,47.4%,68.4%,89.5%.The 95th percentile of the incubation period at primipara was 16.25h,multipara was 10.78h;the 95th percentile of the active period at primipara was 7.69h,multipara was 4.43h,the 95th percentile of the second stage at primipara was 3,25h,multipar was 1.86h.6.According to the new labor standard processing of labor,active period stagnation rate was significantly lower than the old standard of labor(P<0.05);There was no significant difference between the two groups(P>0.05);According to the new labor standard to deal with abnormal labor can reduce the incidence of abnormal labor and the cesarean section rate.Conclusions:1.After a standardized clinical management,maternal with pregnancy.complications can vaginal delivery,pregnancy complications are not indications for cesarean section.2.The longer the interval time between this pregnancy and the last,the longer of the labor time.3.The prolongation of second stage of labor,can increase the rate of episiotomy,to a certain extent,can increased the forceps and postpartum hemorrhage rate,but does not increase the risk of severe perineal laceration and neonatal asphyxia.4.There are individual differences in the starting point of the active period.Most of them are located in the dilatation of cervix from 3cm to 6cm,and the majority of maternal enter the active period after 6cm.5.Application of new labor standards to observe and control the labor can reduce the incidence of abnormal labor and the cesarean section rate.