Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Copenhagen K, Denmark.
Int J Gynaecol Obstet. 2010 Oct;111(1):8-12. doi: 10.1016/j.ijgo.2010.04.031. Epub 2010 Jun 19.
To evaluate the management of prolonged labor and neonatal care before and after Advanced Life Support in Obstetrics (ALSO) training.
Staff involved in childbirth at Kagera Regional Hospital, Tanzania, attended a 2-day ALSO provider course. In this prospective intervention study conducted between July and November 2008, the management and outcomes of 558 deliveries before and 550 after the training were observed.
There was no significant difference in the rate of cesarean deliveries owing to prolonged labor, and vacuum delivery was not practiced after the intervention. During prolonged labor, action was delayed for more than 3 hours in half of the cases. The stillbirth rate, Apgar scores, and frequency of neonatal resuscitation did not change significantly. After the intervention, there was a significant increase in newborns given to their mothers within 10 minutes, from 5.6% to 71.5% (RR 12.71; 95% CI, 9.04-17.88). There was a significant decrease from 6 to 0 neonatal deaths before discharge among those born with an Apgar score after 1 minute of 4 or more (P=0.03).
ALSO training had no effect on the management of prolonged labor. Early contact between newborn and mother was more frequently practiced after ALSO training and the immediate neonatal mortality decreased.
评估高级产科生命支持（ALSO）培训前后对延长产程的管理和新生儿护理。
坦桑尼亚卡盖拉地区医院参与分娩的工作人员参加了为期两天的 ALSO 提供者课程。在 2008 年 7 月至 11 月期间进行的这项前瞻性干预研究中，观察了培训前的 558 次分娩和培训后的 550 次分娩的管理和结果。
由于延长产程而进行剖宫产的比率没有显著差异，并且干预后没有进行真空分娩。在延长产程期间，一半的情况下行动延迟了 3 个多小时。死产率、阿普加评分和新生儿复苏的频率没有明显变化。干预后，在 10 分钟内将新生儿交给母亲的比例显著增加，从 5.6%增加到 71.5%（RR 12.71；95%CI，9.04-17.88）。在 1 分钟后 Apgar 评分为 4 或以上的新生儿中，出生后新生儿死亡率从 6 例降至 0 例（P=0.03）。
ALSO 培训对延长产程的管理没有影响。ALSO 培训后，新生儿与母亲的早期接触更频繁，立即新生儿死亡率下降。
