Effects Of New And Old Labor Standard Management On Maternal And Infant Outcomes

Objective:To understand the difference of cesarean section rate,cesarean section indication,length of labor and maternal and infant outcomes under the management of the new and old labor procedure standards,and explore the advantages of the new labor procedure standards.Methods:Clinical data of hospitalized parturients who delivered in Three Gorges Hospital affiliated to Chongqing University from July 2013 to June 2014,July 2018 to June 2019,and July 2020 to June 2021 were retrospectively collected.A total of 2863 parturients were collected as research objects.They were divided into:Old stage group(382 cases),new stage A group(1296 cases),new stage B group(1185 cases).In the old labor process group,Friedman labor process standard was used for labor process management,and in the new labor process group A and B,new labor process standard was used for labor process management.Results:(1)The rate of cesarean section in new stage A group was lower than that in old stage,7.9%(103/1296)and 24.1%(92/382),respectively.The rate of cesarean section in group B was lower than that in group A 5.3%(63/1185)and 7.9%(103/1296),respectively,and the differences were statistically significant(P<0.05).(2)In the old stage of labor group,92 cases of cesarean section during labor,the top three surgical indicators were social factors 38.0%(35/92),abnormal time of labor 22.8%(21/92),and fetal distress 19.6%(18/92).Among the 103 cases of cesarean section in group A,the top three surgical indication ratios were fetal distress 42.7%,(44/103),abnormal cephalic fetal position 21.4%(22/103)and social factors 17.5%(18/103).In group B,there were 63 cases of cesarean section during labor,and the top three surgical indicators were fetal distress 41.3%(26/63),abnormal cephalic fetal position 23.8%(15/63),and social factors 17.4%(11/63).The rate of cesarean section in the new labor course group A was lower than that in the old labor course group due to social factors and labor course time limit,with statistical significance(P<0.05).The rate of cesarean section due to fetal distress,abnormal cephalic fetal position and relative misalignment of cephalic basin in group A of new labor process was higher than that in group A of old labor process,and the difference of composition ratio of fetal distress was statistically significant(P<0.05).The composition ratio of cesarean section in group B was lower than that in group A due to social factors,fetal intrauterine distress and relative cephalic basin asymmetry,and the difference of relative cephalic basin asymmetry was statistically significant(P<0.05).(3)The first stage of labor,the second stage of labor and the total stage of labor in the old stage group were 290.00(180.00,465.00)min,25.00(15.00,39.25)min and 330.00(219.25,496.25)min,respectively.The first stage of labor time,second stage of labor time and total stage of labor time in group A and B were 350(240.00,520.00)min and 420(269.75,620.00)min,35.00(20.00,58.00)min and 43.00(23.00,73.00)min,405.00(271.50,590.00)min and 469.50(308.00,700.00)min were longer than those in the old labor stage group.The corresponding time of new labor course in group B was longer than that in group A,with statistical significance(P<0.05).There was no significant difference in total labor time over 24h between group B and group A(P>0.05).(4)The rate of lateral episiotomy,Apgarl min ≤7 min ratio,neonatal asphyxia rate and postpartum hospitalization days were 67.2%,6.8%,5.2%and 3(2,4)days,respectively.The rate of lateral perineal resection,Apgarl min<7 min ratio,neonatal asphyxia rate and postpartum hospitalization days in group A were 23.9%,3.4%,3.0%and 3(2,3)days,respectively.The rate of lateral perineal resection,Apgarl min ≤7 min ratio,neonatal asphyxia rate and postpartum hospitalization days in group B were 22.9%,2.7%,2.7%and 2(2,3)days,respectively.The lateral perineal resection rate,Apgarl min ≤7 min ratio,neonatal asphyxia rate and postpartum hospitalization days in group A of the new labor process were lower than those in the old labor process group,with statistical significance(P<0.05).The rates of postpartum bleeding(0.8%vs 0.8%),deep perineal lacerations(0.1%vs 0.0%),neonatal referral rates(3.9%vs 4.7%),and neonatal weight(3293.17±372.70g vs 3259.74±396.70g)(P>0.05).The incidence of postpartum bleeding(0.9%vs 0.8%),episiotomy(22.9%vs 23.9%),severe perineal laceration(0.1%vs 0.1%),Apgar ≤7 min(2.7%vs 3.4%),and neonatal asphyxia(2.7%vs 3.0%),neonatal referral rate(2.7%vs 3.0%),length of postpartum hospital stay(2 days vs 3 days),and neonatal weight(3269.21±366.53g vs 3293.17±372.07g)had no statistical significance(P>0.05).Conclusion:1.The implementation of the new process of labor standard management,cesarean section rate significantly decreased,vaginal trial delivery success rate increased,and further improve,increase the opportunity for pregnant women to fully trial delivery.2.The implementation of new birth process standards can effectively reduce the adverse outcomes of mothers and children.3.With the skilled implementation of the new labor process standard,the labor process time has been further extended,while the adverse outcomes of mothers and children have not increased,and the length of postpartum hospitalization has been continuously shortened,effectively reducing the social and economic burden.Therefore,compared with the old birth process standard,the new birth process standard has obvious advantages,and is worth further promotion.