A Comparative Study Of The New Partogram And Traditional Partogram For Clinical Application

Objective:To investigate the value of new partogram in the clinical application,and to compare the changes of delivery mode and birth outcomes of primiparas under new and old labor management.Methods:763 primiparas suffered vaginal trial production and delivered a single birth in Gansu Provincial Maternity and Child-care Hospital from June 1,2014 to July 31 st were selected as the old labor group.And 659 primiparas suffered vaginal trial production and delivered a single birth in Gansu Provincial Maternity and Child-care Hospital from June 1,2015 to July 31 st were selected as the new labor group.The clinical data of the two groups were analyzed,and the results between the two groups were compared,including the characters of labor process and maternal and neonatal outcomes.SPSS 19.0 software was used for statistical analysis.Results:1.There were 686 cases of vaginal delivery and 15 cases of vagina surgical delivery among the 763 cases in the old labor group.The new labor group had 659 cases,including 618 cases of vaginal delivery and 14 cases in vagina surgical delivery.The baseline characters between the two groups have no significant difference,including age,gestational age,years of education,height,the BMI of women before pregnancy(P > 0.05).2.The differences between two groups in terms of gestational hypertension disease,gestational diabetes mellitus,Vaginal Birth after Cesarean(VBAC),pregnancy associated with cardiac disease,and intrahepatic cholestasis of pregnancy were not significant(P > 0.05).The differences of the pregnancy complications between two groups,which include Umbilical cord(entanglement 1 cycle),Umbilical cord(entanglement≥2 cycles),polyhydramnios,oligohydramnion,and premature rupture of membranes,have no statistical significant(P > 0.05).3.The two groups delivered through cesarean section or vaginal labor were not adverse on maternal outcomes.The difference in terms of episiotomy,postpartum urinary retention,postpartum hemorrhage,perineal oedema,perineal incision infection rate between the two groups were not significantly different(P>0.05).4.The Apgar score of newborn,Umbilical artery blood PH had no significant difference between two groups(P>0.05).The fetal distress,neonatal asphyxia,neonatal jaundice,the rate of neonatal into NICU,meconium stained amniotic fluid,and Inhalation of Meconium in the new labor group had no significant difference compared to the old labor group(P>0.05),and the pelvic floor muscle between two groups had no significant difference(P>0.05).5.There was no significant difference(P<0.05)in term of the rate of cesarean section between the two groups.For the main indications of cesarean section,prolonged latent phase in the new labor group was statistically significantly lower than that in the old labor group(P< 0.05).Whereas in the medical intervention aspects,such as application of oxytocin,artificial rupture of membranes,using diazepam,the difference was statistically significant(P<0.05).6.The average duration of prolonged latent phase and the second stage in new labor group was statistically significantly longer than that of the old group(P<0.05),while the average duration of active period in the new labor group was statistically significantly shorter than that of the old group(P<0.05).Conclusion:1.Through the comparison of the new partogram and traditional partogram,this study found that using the new figure could considerably reduce the rate of cesarean delivery which was transferred from natural delivery,for primipara with the characteristics of full-term,single child labor,head position and natural childbirth.2.After comparing the two groups,we found that using new labor figure to manage labor can reduce extra medical intervention,but cannot increase adverse maternal and neonatal outcomes.3.In this study,we found that the application of new labor group could neither increase the complication of mother and neonate,nor affect the occurrence of pelvic floor dysfunction in six weeks after delivery.However,it still needs large sample and multicenter clinical randomized controlled study for further study.4.New labor figure was also suitable for those pregnant women with complications,so it is worth promoting for clinical application.But for safety,the new labor figure should first be used in those hospitals with good facilities.