新产程标准下产程中转剖宫产影响因素研究进展

随着我国新产程标准的实施,阴道分娩率增加,首次剖宫产率降低,但以胎儿窘迫、产程中发热为指征的产程中转剖宫产增加,产程中转剖宫产导致母儿并发症的风险增加。阴道分娩是一个复杂的生理过程,在影响分娩的各个因素中,孕妇年龄、身高、体质量指数、孕周、引产方式、胎膜早破和分娩镇痛等都是预测产程中转剖宫产的有价值的指标,单一某因素的异常不一定会导致产程中转剖宫产,但多种影响因素叠加时,产妇虽无剖宫产指征,产程中发生中转剖宫产的概率明显增加。因此,在产程中识别和关注中转剖宫产的高危因素,把握剖宫产的手术指征和手术时机十分重要。现对新产程标准下产程中转剖宫产的影响因素进行综述,以期为构建产程中转剖宫产的风险预测模型提供方向。

Research Progress on Influencing Factors of Intrapartum Cesarean Section in New Labor Standard

With the implementation of the new labor standard in China, the vaginal delivery rate increases, the primary cesarean section rate decreases, but cesarean sections during labor indicated by fetal distress and intrapartum fever increase, intrapartum cesarean section will increases the risk of complications for mothers and neonatus. Vaginal delivery is a complex physiological process. During this process, influencing factors such as age, height, body mass index, gestational age, induced labor method, premature rupture of membranes and labor analgesia are valuable predictors of intrapartum cesarean section. One abnormal factor may not leads to intrapartum cesarean section, but the superposition of multiple influencing factors may significantly increase the probability, even the puerpera has no cesarean section indications. Therefore, it is very important to identify the risk factors of cesarean section during labor and control the indications and timing of cesarean section. It is planned to summarize the influencing factors of intrapartum cesarean section under the new labor standard, in order to provide directions for the construction of risk prediction model of intrapartum cesarean section.