Millen Katherine Rodewald, Kuo Kelly, Zhao Lulu, Gecsi Kimberly
Fellow, Maternal-Fetal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
Resident Physician, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, MacDonald Women's Hospital, Case Western Reserve University, Cleveland, OH.
Obstet Gynecol Surv. 2014 Apr;69(4):209-17. doi: 10.1097/OGX.0000000000000057.
Evidence-based care of women in labor requires a thorough understanding of both "normal" and abnormal labor progress. In response to the growing cesarean delivery rate for dystocia at our institution, a multidisciplinary team of attending physicians, nurse-midwives, resident physicians, and nurses was established to review the literature and create evidence-based guidelines. This article describes the background literature and consensus guidelines reached for the diagnosis of active phase labor, active phase arrest, second-stage arrest, protraction of the active phase, and failed induction of labor. Our review illustrates that slower labor patterns than traditionally described often result in a vaginal delivery without unacceptable increases in maternal or neonatal morbidity.
基于证据的分娩期妇女护理需要全面了解“正常”和异常的产程进展。针对我院因难产导致的剖宫产率不断上升的情况，成立了一个由主治医生、助产士、住院医生和护士组成的多学科团队，对文献进行回顾并制定基于证据的指南。本文描述了关于活跃期分娩、活跃期停滞、第二产程停滞、活跃期延长和引产失败的诊断的背景文献及达成的共识指南。我们的回顾表明，与传统描述相比更缓慢的产程模式通常能实现阴道分娩，且不会导致孕产妇或新生儿发病率出现不可接受程度的增加。
