背景:弗里德曼的标准,大约50年前发展起来的,可能不再符合当今产科人群的需求和当前的妊娠管理实践。本研究旨在分析中国当代劳动模式并估计劳动持续时间,重点关注中国自发分娩产妇的第一阶段分娩数据。
方法:这项回顾性观察研究利用了长沙某三甲医院的电子病历数据,湖南。在总共2689名产妇中,排除了多次妊娠,早产,学期结束后,或者死产,剖宫产,非顶点表示,和新生儿重症监护病房入院。平均劳动力曲线是使用重复测量分析通过平价构建的,劳动持续时间是通过间隔审查回归估计的,入院时宫颈扩张分层。我们进行了一项分析以评估催产素增强和羊膜切开术对分娩进展的影响,并对结局复杂的女性进行了敏感性分析。
结果:未产妇女从3到4厘米宫颈扩张需要超过180分钟,从5到6厘米的持续时间超过145分钟。多产妇女的分娩时间比未产妇女短。在未产中5厘米后观察到分娩加速,但是在平均劳动力曲线中没有明显的拐点。在劳动的第二阶段,未产的第95百分位数,有或没有硬膜外镇痛,是142分钟和127分钟,分别。
结论:这些发现为重新评估当代产科人群的分娩和分娩过程提供了有价值的见解,包括目前的中国产科实践。
BACKGROUND: Friedman\'s standards, developed almost 50 years ago, may no longer align with the needs of today\'s obstetric population and current pregnancy management practices. This study aims to analyze contemporary labor patterns and estimate labor duration in China, focusing on first-stage labor data from Chinese parturients with a spontaneous onset of labor.
METHODS: This retrospective observational study utilized data from electronic medical records of a tertiary hospital in Changsha, Hunan. Out of a total of 2,689 parturients, exclusions were made for multiple gestations, preterm, post-term, or stillbirth, cesarean delivery, non-vertex presentation, and neonatal intensive care unit admission. Average labor curves were constructed by parity using repeated-measure analysis, and labor duration was estimated through interval-censored regression, stratified by cervical dilation at admission. We performed an analysis to assess the impact of oxytocin augmentation and amniotomy on labor progression and conducted a sensitivity analysis using women with complicated outcomes.
RESULTS: Nulliparous women take over 180 minutes for cervical dilation from 3 to 4 cm, and the duration from 5 to 6 cm exceeds 145 minutes. Multiparous women experience shorter labor durations than nulliparous. Labor acceleration is observed after 5 cm in nulliparous, but no distinct inflection point is evident in the average labor curve. In the second stage of labor, the 95th percentile for nulliparous, with and without epidural analgesia, is 142 minutes and 127 minutes, respectively.
CONCLUSIONS: These findings provide valuable insights for the reassessment of labor and delivery processes in contemporary obstetric populations, including current Chinese obstetric practice.