The Effect Of New Standard Of Labor Procedure On Delivery Mode And Outcome Of Mother And Child

Objective:To explore the influence of delivery mode,cesarean section indication distribution and changes,and the length of labor process on maternal and infant outcomes after the implementation of the new labor process standard in our hospital.Methods:Extracting and collecting data from the register of obstetrical births and electronic medical records from the affiliated Hospital of Hebei Engineering University,and retrospectively collecting clinical data on maternal and fetal survival in hospital births from January 2014 to June 2014,January 2016 to June 2016,A total of 595 cases of fetal malformations were excluded from stillbirth.293 parturients from January 2014 to June 2014 were divided into control group and 302 parturients from January 2016 to June 2016 as observation group.According to the time of the implementation of the new labor process standard,the pregnant women in the control group who had the desire to have a vaginal trial were treated with the Friedman labor process standard for the intervention and treatment of the labor process.The pregnant women in the observation group who had the desire to have a vaginal trial were treated with the new labor process standard proposed by the Department of Gynecology and Obstetrics of the Chinese Medical Association in 2014.A statistical analysis was carried out to compare the changing trend of the delivery mode after the opening of the comprehensive twochild policy,the change of the composition ratio of the indications of cesarean section and the conversion to cesarean section,and the influence of the time limit of the second stage of labor on the outcome of the mother and child.SPSS V22.0 software package(IBM,Armonk,NY)was used for data analysis.The continuous variable satisfies the normal distribution by t-test,and the data is expressed by x-table s.The chi-square test applies to classified variables,and the data is expressed as examples and percentages.When P value was less than 0.05,the difference was significant.Results:In this study,there were a total of 595 pregnant women,including 293 in the control group and 302 in the observation group.There were no statistically significant differences in age,gestational age,gestational age,number of births,and educational level between the two groups,and the clinical data were comparable.(1)in the observation group,the women who were willing to have vaginal trial labor andfinally succeeded in vaginal delivery were higher than the control group,the cesarean section rate was slightly lower than the control group,the vaginal midwifery rate was slightly higher than the control group,but there was no significant difference after statistical treatment(P>0.05);(2)scar uterus,dystocia,pregnancy complications and complications were the main indications of cesarean section in the two groups,and the composition ratio of scar uterus was the first indication of cesarean section in the two groups.The composition ratio of cesarean section pregnancy complications,social factors and breech position in the observation group was lower than that in the control group,and the composition ratio of dystocia and other factors was higher than that in the control group,with statistically significant differences(P<0.05).There was no significant difference in the composition of intrauterine distress between the two groups(P>0.05).(3)the composition ratio of abnormal head position fetal bearing,fetal intrauterine distress and abnormal labor duration was higher in the observation group than in the control group,among which the composition ratio of fetal intrauterine distress and abnormal head duration was statistically significant(P<0.05),and there was no statistically significant difference between the two groups(P>0.05).In the observation group,the proportion of parturients who had failed vaginal trial delivery due to non-weighting of the head and pelvis and the umbilical cord factor as the indicator to transfer cesarean section was lower than that in the control group,and the difference of the proportion of parturient head and pelvis was statistically significant(P<0.05).Although the difference of social factors was not statistically significant,the rank of social factors changed from the second to the fifth.(4)there were statistically significant differences between the observation group and the control group in the length of labor in the first,second,total and second stages of labor over 2 hours(P<0.05).(5)the incidence of episiotomy in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Two groups of postpartum hemorrhage,turn new pediatric,depth of perineal laceration(?/? degree laceration),birth weight,there was no statistically significant difference(P > 0.05).Conclusions:After our hospital implemented the new standard of labor procedure,the total cesarean section rate showed a downward trend,and the rate of successful vaginal delivery increased,which increased the chance of full trial delivery.The relaxation of the time limit for the second labor reduces unnecessary labor intervention and does not increase the incidence of maternal and child complications.The newstandard of labor process is suitable for Chinese labor population and should be worth popularizing.