Chen Hongqin, Cao Liyuan, Cao Wen, Wang Hui, Zhu Cairong, Zhou Rong
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu.
West China School of Public Health, Sichuan University, Sichuan, China.
Medicine (Baltimore). 2018 Dec;97(52):e13901. doi: 10.1097/MD.0000000000013901.
The aim of the study was to explore the role of parity, maternal age, medical interventions, and birth weight with respect to labor duration and cervical dilation.A total of 1601 pregnant women who had a singleton term gestation, spontaneous onset of labor, vertex presentation, vaginal delivery, and a normal perinatal outcome were reviewed. The retrospective study was conducted in patients from West China Second University Hospital of Sichuan University during June 2008 to June 2013.There were 1367 nulliparous women and 234 multiparous women analyzed. The first stage (8.3 ± 3.8 vs 5.0 ± 2.6 hours), latent phase (5.1 ± 3.2 vs 3.5 ± 2.4 hours), active phase (3.2 ± 1.8 vs 1.5 ± 1.0 hours), second stage (44 ± 31 vs 18 ± 14 minutes), and total stage of labor (9.1 ± 3.9 vs 5.4 ± 2.6 hours) were all longer in nulliparous than in multipara women (all P < .05); but no significant difference in the third stage of labor (both 7 ± 4 minutes). In nulliparous women, the average time of first stage of labor increased by 58.257, 171.443, and 56.581 minutes due to artificial rupture of membranes, labor analgesia, and birth weight increased by 1 kg, respectively, but it decreased to 63.592 minutes by oxytocin usage, and the difference was significant. The average time of first stage of labor in nulliparous women aged from 26 to 30 years increased by 2.356 minutes compared to one in 20 to 26 years, but it increased by 1.802 minutes to the one in 30 to 39 years, compared to 20 to 26 years and the difference was not significant. The results were basically similar after multipara women were included.Labor was significantly shorter in multiparous women than that in nulliparous women. Increased birth weight significantly increased in the length of the active phase and the second stage among nulliparous women. The increase of age, artificial rupture of membranes, labor analgesia, and the increase of birth weight tends to increase the time of first stage of labor and total labor duration, whereas oxytocin could shorten it.
本研究的目的是探讨产次、产妇年龄、医疗干预措施及出生体重对产程和宫颈扩张的影响。共纳入1601例单胎足月妊娠、自然临产、头先露、经阴道分娩且围产期结局正常的孕妇。回顾性研究对象为四川大学华西第二医院2008年6月至2013年6月期间的患者。分析了1367例初产妇和234例经产妇的数据。初产妇的第一产程（8.3±3.8小时 vs 5.0±2.6小时）、潜伏期（5.1±3.2小时 vs 3.5±2.4小时）、活跃期（3.2±1.8小时 vs 1.5±1.0小时）、第二产程（44±31分钟 vs 18±14分钟）及总产程（9.1±3.9小时 vs 5.4±2.6小时）均长于经产妇（均P<0.05）；但第三产程无显著差异（均为7±4分钟）。在初产妇中，人工破膜、分娩镇痛及出生体重每增加1kg，第一产程平均时间分别增加58.257、171.443和56.581分钟，而使用缩宫素可使其缩短至63.592分钟，差异有统计学意义。26至30岁初产妇的第一产程平均时间较20至26岁初产妇增加2.356分钟，较20至26岁初产妇，30至39岁初产妇的第一产程平均时间增加1.802分钟，差异无统计学意义。纳入经产妇后结果基本相似。经产妇的产程明显短于初产妇。出生体重增加使初产妇活跃期和第二产程时间显著延长。年龄增加、人工破膜、分娩镇痛及出生体重增加均倾向于延长初产妇第一产程及总产程时间，而缩宫素可缩短产程。
