| Objective:To investigate the maternal delivery mode in one hospital of Tianjin in 2014,and explore the influencing factors of choosing doula delivery and postpartum hemorrhage after 24 hours of doula delivery mode.Methods: 4358 qualified maternal and neonatal children's information were collected in a three-level comprehensive public hospital of Tianjin from January 1,2014 to December 31,2014.Measurement data which normal distribution were described by(?),statistical inferenced by t-test and ANOVA.Measurement data which skewed distribution were described by M(Q1,Q3),statistical inferenced by rank-sum test.Categorical data were described by n(%),statistical inferenced by Chi-square test.Logistic regression was used to analyze the factors influencing doula delivery with SPSS 19.0.Quantile regression was used to analyze the factors influencing 24 hours postpartum hemorrhage with stata 120.Results: 1.The median of maternal age was 30 years.The rate of cesarean group was high(56.6%),compared with the natural labour group(30.7%)and the doula group(12.7%).2.In doula group,the rate of first pregnant,first labour,partus mature,single birth,cephalic position was 73.60%,96.02%,91.68%,99.46%,98.73%,respectively.In 553 doula cases,the median of maternal age was 29 years and the median of hospitalization was 4 days.There are 6 cases appear to mild asphyxia and there is no severe asphyxia in neonatus.The median of neonatal weight was 3320 g.3.In natural labour group,the rate of first pregnant,first labour,partus mature,single birth,cephalic position was 61.63%,81.68%,86.69%,99.03%,97.83%,respectively.The median of maternal age was 29 years and the median of hospitalization was 4 days.There are 13 cases appear to mild asphyxia and 11 cases of severe asphyxia in 1337 natural labour cases.The median of neonatal weight was 3270 g.4.In caesarean group,the rate of first pregnant,first labour,partus mature,single birth,cephalic position was 52.71%,78.48%,85.25%,95.06%,85.29% respectively.The median of maternal age was 30 years and the median of hospitalization was 4 days.There are 27 cases appear to mild asphyxia and 15 cases of severe asphyxia in 2468 caesarean cases.The median of neonatal weight was 3270 g.5.The ratio of assisted delivery was 86.44% in doula group which was higher than that of natural labour group(76.26%).6.Logistic regression analysis showed that amniotic fluid,fetal position,placenta,elderly primipara,scar uterus,pregnancy hypertension,anemia,gravida para were medical factors which influce the choice of doula delivery.7.The quantile regression analysis showed that the uterus of the scar uterus,fetal weight,the second stage of labour and the third stage of labor were the influencing factors of 24 hours postpartum hemorrhage.Conclusion: 1.The rate of cesarean delivery in the hospital is at a high level,while the social factors which lead to cesarean delivery play an small part.Reducing cesarean rate which caused by social factors is an important task for the hospital.2.Compared with natural delivery,Doula delivery prolong duration of labor of the primipara,while the duration of labor is in the normal range.Doula delivery could relieve the pain of labor and reduce the cesarean section rate,what's more,doula delivery do not affect the Apgar score.We can promote doula delivery in clinical.3.During labour when using doula delivery,we must pay attention to maternal amniotic fluid,fetal,placental,maternal age,uterine scar,hypertension syndrome,especially maternal uterine scar.The indication for vaginal delivery whose uterus with scar should be more strictly controlled. |
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