The Effects Of Change In Labor Time On The Maternal And Neonatal Outcomes

Objective:To explore the influence of the different duration of labor on maternal and neonatal outcomes.Methods:Data were collected from electronic medical record data in the second hospital of Jilin University.Study population included 1058 primiparous women who did not use epidural analgesia with singleton,term gestation,livebirths delivered vaginally in cephalic presentation at term time between January 2016 and december 2016.The1058 cases were divided into 4 groups,according to the duration of the second stage?t?:Study Group A₁ with t<1h,Study Group A₂ with 1h?t<2h,Study Group A₃with 2h?t<3h,Study Group A₄ with 3h?t.Women who did not record the third stage of labor or the third stage of labor more than half an hour were excluded from the study.Remaining cases were divided into the nulliparous group?B₁?and the multiparous group?B₂?.Finally,divided them into 3 groups depending on the third stage duration?t?:Study Group C₁ with t<10min,Study Group C₂ with 10min?t<20min,Study Group C₃ with 20min?t<30min.Observe the effects of different second labor duration and third labor duration on maternal and neonatal outcomes,respectively.Statistics were performed using Chi-square test,Fisher exact test,t-test.In the case of multiple comparisons,the Bonferroni correction was applied.P<0.05or P'<0.0083 was considered statistically significant.Results:?1??1?A₁,A₂,A₃,A₄ between the four groups,the rates of maternal pregnancy complications?such as hypertensive pregnancy,premature rupture of membranes,thrombocytopenia,etc?,postpartum fever,perineal integrity,perineal edema,postpartum hemorrhage,Apgar score?7,admission to the neonatology department were not statistically significant differences?P>0.05?.Although the proportion of maternal gestational diabetes with the increase of the second stage of labor gradually increased,but no differences in the rates of maternal gestational diabetes between the four groups?P>0.05?.?2?The rate of episiotomy increased gradually with the extension of the second stage of labor,and there was a significant difference?P<0.01?.There is a difference in episiotomy rate?P<0.05?.A comparison between the two groups showed that the A₄ group had significant higher rate of forceps delivery than the other 3 groups,and the difference was statistically significant?P'<0.0083?.The rate of episiotomy in group A₂,group A₃ and group A₄ were significantly higher than in group A₁?P'<0.0083?.The sum of the A₂ group,the A₃ group,and the A₄ group was significantly different from the A₁ group in forceps delivery?P<0.01?.?3?The difference in the ratio of macrosomia between the four groups was statistically significant?P<0.01?.And,the longer the second stage of labor,the greater the proportion of macrosomia.A two-two comparisons found that the ratio of macrosomia in the A₂,A₃,and A₄ groups all were higher than the A₁ group,and the difference was statistically significant?P'<0.0083?.The sum of the A₂ group,the A₃ group,and the A₄ group was significantly different from the A₁ group in macrosomia?P<0.01?.?2?The B₂ group had a significantly longer duration of third labor than the B₁ group?P<0.05?.?3?With the extension of the third stage of labor,the number of natural delivery of placenta decreased significantly,and the amount of postpartum hemorrhage increased.The amount of postpartum hemorrhage in C₃ group was higher than that in C₂ group and C₁ group,and the difference was statistically significant?P<0.05?.Conclusion:?1?As the second stage of labor was prolonged,the rates of episiotomy increased,when the second stage of labor?1 hour rises most significantly,but the incidence of postpartum hemorrhage and short-term neonatal complications did not increase.?2?The longer the second stage of labor,the greater the proportion of macrosomia.?3?When the duration of the second labor is?3 h,the rate of the forceps delivery was significantly increased.?4?Multiple pregnancies were longer than the third stage of labor in the first pregnancy.?5?When the third stage of labor was?20 min,the amount of postpartum hemorrhage increases significantly.