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目的分析产程中活跃期停滞与妊娠结局的关系。方法对2009年1月1日至2009年12月31日期间,在北京大学第一医院诊断为活跃期停滞的足月、单胎、头位初产妇,进行回顾性研究。应用单因素和多因素回归分析等方法,比较活跃期停滞产妇剖宫产分娩组与阴道分娩组的不同特点,比较阴道分娩产妇活跃期停滞组与无活跃期停滞组的不同特点。探讨活跃期停滞、分娩方式与母婴结局之间的关系。结果 417例活跃期停滞产妇被纳入本研究,其中212例(50.8%)经阴道分娩,另外205例(49.2%)经剖宫产分娩。与剖宫产组相比,阴道分娩组产妇分娩前BMI更低,新生儿平均出生体重更小。绒毛膜羊膜炎、产褥感染、产后出血、严重产后出血及输血发生率,在剖宫产组均明显高于阴道分娩组(P<0.05)。这些产妇并发症与剖宫产分娩有相关性。新生儿并发症在两组中差异无统计学意义(P>0.05),也与剖宫产分娩无相关性。结论活跃期停滞发生时尝试阴道分娩,也许可减少与剖宫产分娩相关的并发症,且阴道分娩并不增加新生儿不良事件的发生。
Objective To analyze the relationship between active phase stagnation and pregnancy outcome in labor. Methods From January 1, 2009 to December 31, 2009, a retrospective study was conducted on full-term, single-birth and first-position primipara in the first phase of Peking University First Hospital. Univariate and multivariate regression analysis methods were used to compare the characteristics of cesarean section delivery group and vaginal delivery group in active stagnant women and to compare the different characteristics of active vaginal delivery group and inactive vaginal delivery group. To investigate the relationship between active stagnation, mode of delivery and maternal-infant outcome. RESULTS: A total of 417 active stagnant women were enrolled in this study. 212 (50.8%) were delivered vaginally and another 205 (49.2%) were delivered by cesarean section. Compared with the cesarean section group, vaginal delivery group maternal BMI before delivery is lower, the average newborn birth weight smaller. Chorioamnionitis, puerperal infection, postpartum hemorrhage, severe postpartum hemorrhage and transfusion incidence were significantly higher in the cesarean section group than in the vaginal delivery group (P <0.05). These maternal complications are associated with cesarean delivery. Neonatal complications in the two groups showed no significant difference (P> 0.05), but also had no correlation with cesarean delivery. Conclusions Vaginal delivery at the onset of active phase arrest may reduce the complications associated with cesarean delivery and vaginal delivery does not increase the incidence of neonatal adverse events.