Effects of new standard of labor stage on perinatal outcomes of low-risk puerperae

Abstract

Objective To investigate the effects of the implementation of Expert Consensus on the New Standard and Treatment of Labor Stage new standard of labor stage on perinatal outcomes in low-risk puerperae. Methods A total of 2 066 low-risk puerperae who were hospitalized in the Department of Obstetrics of First Affiliated Hospital of Army Military Medical University from July 1, 2015 to June 30, 2016 and were managed by new standard of labor stage, were selected and included into study group. Meanwhile, another 2 108 low-risk puerperae who were managed by old standard of labor stage in the same hospital from July 1, 2014 to June 30, 2015 were selected and included into control group. The following items were retrospectively analyzed and compared, general clinical data (age, height, weight, gestational age), modes of delivery (intrapartum cesarean section, forceps delivery, vaginal delivery), composition ratio of indications for intrapartum cesarean section, incidence of postpartum hemorrhage of parturient, Apgar score and birth weight and incidence of neonatal asphyxia of newborns. The general clinical data(age, height, weight, gestational age), newborn birth weight and Apgar score of newborns between two groups were statistically analyzed by independent-samples t test. The amount of postpartum hemorrhage were statistically analyzed by Mann-Whitney U rank sum test. The incidence of intrapartum cesarean section, forceps delivery and vaginal delivery were statistically analyzed by chi-square test. The procedures followed in this study were in accordance with the ethical standards established by the Human Subjects Trial Committee of First Affiliated Hospital of Army Medical University, and this study was approved by this committee [Approval No. 2014(102)]. Informed consent was obtained from each individual participant included in the study. Results ①There were no significant differences between two groups in the general clinical data and birth weight of newborns (P>0.05). ②The intrapartum cesarean section rate and forceps delivery rate in study group were 27.4% (566/2 066) and 2.4% (50/2 066) respectively, which were significantly higher than those of control group 36.7% (774/2 108) and 8.1% (171/2 108), while the vaginal delivery rate of study group was 70.2% (1 450/2 066), which was significantly lower than that of control group 55.2% (1 163/2 108), and the differences were statistically significant (χ2=41.592, 67.412, 100.451; all P 0.05). ⑤ There were no significant differences between two groups in Apgar score of 1 min and 5 min after birth and incidence of neonatal asphyxia (P>0.05). Conclusions New standard of laber stage can reduce the incidence of intrapartum cesarean section and forceps delivery, promote vaginal delivery in low-risk puerperae, and it will not increase the risk of adverse perinatal outcomes. New standard of labor stage is worthy of clinical application. Key words: Labor, obstetric; New standard of labor stage; Trial of labor; Labor presentation; Anesthesia, epidural; Perinatal care; Pregnancy outcome; Puerperae