Hildingsson Ingegerd, Blix Ellen, Hegaard Hanne, Huitfeldt Anette, Ingversen Karen, Ólafsdóttír Ólof Ásta, Lindgren Helena
Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Birth. 2015 Dec;42(4):346-53. doi: 10.1111/birt.12191. Epub 2015 Oct 15.
Normal progress of labor is a subject for discussion among professionals. The aim of this study was to assess the duration of labor in women with a planned home birth and spontaneous onset who gave birth at home or in hospital after transfer.
This is a population-based study of home births in four Nordic countries (Denmark, Iceland, Norway, and Sweden). All midwives assisting at a home birth from 2008 to 2013 were asked to provide information about home births using a questionnaire.
Birth data from 1,612 women, from Denmark (n = 1,170), Norway (n = 263), Sweden (n = 138), and Iceland (n = 41) were included. The total median duration from onset of labor until the birth of the baby was approximately 14 hours for primiparas and 7.25 hours for multiparas. The duration of the different phases varied between countries. Blood loss more than 1,000 mL and perineal ruptures that needed suturing were associated with a longer pushing phase and the latter with country of residence, parity, single status, and the baby's weight.
In this population of healthy women with a low prevalence of interventions, the total duration of labor was fairly similar to what is described in the literature for multiparas, but longer for primiparas. Although the duration of the phases of labor differed among countries, it was to a minor extent associated with severe outcomes.
正常分娩进展是专业人士讨论的话题。本研究的目的是评估计划在家分娩且自然发动的女性,在在家分娩或转院后在医院分娩的产程时长。
这是一项对四个北欧国家(丹麦、冰岛、挪威和瑞典)在家分娩情况的基于人群的研究。要求所有在2008年至2013年期间协助在家分娩的助产士使用问卷提供有关在家分娩的信息。
纳入了来自丹麦(n = 1170)、挪威(n = 263)、瑞典(n = 138)和冰岛(n = 41)的1612名女性的分娩数据。初产妇从产程开始到婴儿出生的总中位时长约为14小时,经产妇为7.25小时。不同阶段的时长在各国之间有所不同。失血超过1000 mL以及需要缝合的会阴撕裂与较长的第二产程相关,后者与居住国家、产次、单身状况以及婴儿体重有关。
在这群干预发生率较低的健康女性中,总产程与文献中描述的经产妇相当相似,但初产妇更长。尽管各国分娩阶段的时长有所不同,但在较小程度上与严重结局相关。