建立活跃期难产模型并进行验证,这项研究回顾性分析了单胎头颅足月胎儿初产妇的临床资料,在劳动审判后分娩的人。卡方检验,t检验,采用Mann-WhitneyU检验和多因素logistic回归分析进行统计学分析。基于该模型,使用R编程语言建立了列线图。多因素logistic回归分析显示胎儿腹围,胎膜早破(PROM),延长的潜伏期,活跃期早期的胎儿位置和胎儿位置是影响活跃期产程难产的独立因素。该模型可有效、准确地支持临床医师早期识别难产,改善母婴结局。在第一阶段活跃期发生的难产,最常被诊断为分娩异常。以前的研究表明,母亲的年龄,身体质量指数,巨大儿和胎儿位置异常是难产的独立危险因素。然而,只报告了危险因素,建立的预测模型很少。这项研究的结果补充了什么?本研究利用现实世界中的数据,通过逻辑回归分析,建立了在活跃期发生难产的足月单胎初产妇的预测模型。胎儿腹围,PROM,延长的潜伏期,活跃期早期的胎儿位置和胎儿位置是影响活跃期产程难产的独立因素。此外,将列线图建立为视觉图以预测其概率。这些发现对临床实践和/或进一步研究有什么意义?基于预测模型的列线图放弃了复杂的计算,并提出了一种简单的基于视觉图的方法来预测活跃期难产的可能性。它有助于引入可以降低CS率和不良母婴结局发生率的干预措施,以确保母婴安全。
To establish and verify a model for labour
dystocia occurring in the active phase, this study retrospectively analysed the clinical data of primiparas with singleton cephalic full-term foetuses, who had delivered after a trial of labour. The Chi-square test, t-test, Mann-Whitney U test and multivariate logistic regression analysis were used for statistical analysis. Based on the model a nomogram was established using the R programming language. Multivariate logistic regression analysis showed that the foetal abdominal circumference, premature rupture of membranes (PROM), prolonged latent phase, foetal station and foetal position at the early stage of the active phase were independent factors influencing labour
dystocia occurring in the active phase. The established model could effectively and accurately support clinicians in the early identification of labour dystocia to improve maternal and infant outcomes.Impact statementWhat is already known on this subject? Labour
dystocia occurring during the active phase of the first stage, is the most commonly diagnosed as labour aberration. Previous studies have suggested that maternal age, body mass index, macrosomia and abnormal foetal position are the independent risk factors for labour
dystocia. However, only the risk factors were reported, and few prediction models were established.What do the results of this study add? This study uses data in the real world to establish a prediction model of full-term singleton primipara with labour
dystocia occurring in the active phase by logistic regression analysis. Foetal abdomen circumference, PROM, prolonged latent phase, the foetal station and foetal position at the early stage of the active phase are independent factors influencing labour dystocia that occurs in the active phase. In addition, a nomogram is established as a visual graph to predict the probability of it.What are the implications of these findings for clinical practice and/or further research? The nomogram based on the predictive model discarded complicated calculations and presented an easy visual graph-based method to predict the probability of labour dystocia occurring in the active phase. It helps to introduce interventions that could reduce the CS rate and occurrence of adverse maternal and foetal outcomes to ensure the safety of mothers and infants.