Abstract：
OBJECTIVE: To study the changes of intrapartum cesarean rate, cesarean indications and pregnancy outcomes after the new partogram applied.
METHODS: Totally 3 290 pregnant women trying to vaginal delivery which were managed according to the new partogram in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from August to October in 2014(new partogram group)were involved; 2 987 pregnancy women trying to vaginal delivery from May to July in 2014 which were managed according to the old partogram(old partogram group)were involved as control. The intrapartum cesarean rate, cesarean indications and the pregnancy outcomes between the two groups were analyzed.
RESULTS: The rate of intrapartum cesarean delivery was 8.50%(254/2 987)in old partogram group, and was significantly higher than that in new partogram group(6.2%, 204/3 290; P<0.01). Cesarean indications in old partogram group included 18 labor protraction(7.1%, 18/254), 82 labor arrest(32.3%, 82/254), 44 relative cephalopelvic disproportion(17.3%, 44/254), 80 fetal distress(31.5%, 80/254), 23 intrauterine infection(9.1%, 23/254)and 7 cesarean delivery on maternal request(CDMR; 2.8%, 7/254). Cesarean indications in new partogram group included 33 labor arrest(16.2%, 33/204), 71 relative cephalopelvic disproportion(34.8%, 71/204), 73 fetal distress(35.8%, 73/204)and 22 intrauterine infection(10.8%, 22/204), 5 CDMR(2.5%, 5/204). There were no significant differences in incidence of asphyxia neonatorum and puerperal morbidity(P> 0.05), but the incidence of postpartum hemorrhage in new partogram group was higher than the old partogram group[6.9%(14/204)versus 1.6%(4/254), P<0.05].
CONCLUSIONS: After the new partogram applied, the rate of intrapartum cesarean delivery is significantly decreased, but the incidence of postpartum hemorrhage is increased.
METHODS: Totally 3 290 pregnant women trying to vaginal delivery which were managed according to the new partogram in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from August to October in 2014(new partogram group)were involved; 2 987 pregnancy women trying to vaginal delivery from May to July in 2014 which were managed according to the old partogram(old partogram group)were involved as control. The intrapartum cesarean rate, cesarean indications and the pregnancy outcomes between the two groups were analyzed.
RESULTS: The rate of intrapartum cesarean delivery was 8.50%(254/2 987)in old partogram group, and was significantly higher than that in new partogram group(6.2%, 204/3 290; P<0.01). Cesarean indications in old partogram group included 18 labor protraction(7.1%, 18/254), 82 labor arrest(32.3%, 82/254), 44 relative cephalopelvic disproportion(17.3%, 44/254), 80 fetal distress(31.5%, 80/254), 23 intrauterine infection(9.1%, 23/254)and 7 cesarean delivery on maternal request(CDMR; 2.8%, 7/254). Cesarean indications in new partogram group included 33 labor arrest(16.2%, 33/204), 71 relative cephalopelvic disproportion(34.8%, 71/204), 73 fetal distress(35.8%, 73/204)and 22 intrauterine infection(10.8%, 22/204), 5 CDMR(2.5%, 5/204). There were no significant differences in incidence of asphyxia neonatorum and puerperal morbidity(P> 0.05), but the incidence of postpartum hemorrhage in new partogram group was higher than the old partogram group[6.9%(14/204)versus 1.6%(4/254), P<0.05].
CONCLUSIONS: After the new partogram applied, the rate of intrapartum cesarean delivery is significantly decreased, but the incidence of postpartum hemorrhage is increased.
摘要：
目的：研究产时剖宫产率的变化，剖宫产指征和妊娠结局应用新的产程图。
方法：根据新的产程图，在北京妇产医院进行阴道分娩的孕妇共3290例，2014年8月至10月首都医科大学（新产程组）；2014年5月至7月尝试阴道分娩的2987名孕妇作为对照，根据旧产程进行管理（旧产程组）。产时剖宫产率，分析两组剖宫产指征及妊娠结局。
结果：老年分娩组产时剖宫产率为8.50%（254/2987），并且显著高于新模式组(6.2%，204/3290；P<0.01）。老产程组的剖宫产指征包括18个产程(7.1%，18/254),82名劳工逮捕(32.3%，82/254)，44相对头盆比例不照率(17.3%，44/254），80例胎儿窘迫（31.5%，80/254),23例宫内感染（9.1%，23/254）和7应产妇要求剖宫产（CDMR；2.8％，7/254)。新产程组的剖宫产指征包括33例劳动逮捕（16.2％，33/204),71相对头盆比例（34.8％，71/204），73胎儿窘迫(35.8%，73/204）和22宫内感染（10.8％，22/204),5CDMR（2.5%，5/204）。新生儿窒息发生率和产褥期发病率差异无统计学意义(P>0.05),但新产程图组产后出血发生率高于旧产程图组[6.9%(14/204)对1.6%(4/254),P<0.05]。
结论：应用新的模式后，产时剖宫产率显着下降，但产后出血的发生率增加。
方法：根据新的产程图，在北京妇产医院进行阴道分娩的孕妇共3290例，2014年8月至10月首都医科大学（新产程组）；2014年5月至7月尝试阴道分娩的2987名孕妇作为对照，根据旧产程进行管理（旧产程组）。产时剖宫产率，分析两组剖宫产指征及妊娠结局。
结果：老年分娩组产时剖宫产率为8.50%（254/2987），并且显著高于新模式组(6.2%，204/3290；P<0.01）。老产程组的剖宫产指征包括18个产程(7.1%，18/254),82名劳工逮捕(32.3%，82/254)，44相对头盆比例不照率(17.3%，44/254），80例胎儿窘迫（31.5%，80/254),23例宫内感染（9.1%，23/254）和7应产妇要求剖宫产（CDMR；2.8％，7/254)。新产程组的剖宫产指征包括33例劳动逮捕（16.2％，33/204),71相对头盆比例（34.8％，71/204），73胎儿窘迫(35.8%，73/204）和22宫内感染（10.8％，22/204),5CDMR（2.5%，5/204）。新生儿窒息发生率和产褥期发病率差异无统计学意义(P>0.05),但新产程图组产后出血发生率高于旧产程图组[6.9%(14/204)对1.6%(4/254),P<0.05]。
结论：应用新的模式后，产时剖宫产率显着下降，但产后出血的发生率增加。
