Cardozo L D, Gibb D M, Studd J W, Vasant R V, Cooper D J
Br J Obstet Gynaecol. 1982 Jan;89(1):33-8. doi: 10.1111/j.1471-0528.1982.tb04631.x.
From a study of 2000 consecutive labours the outcome of the 684 primigravid patients admitted in spontaneous labour has been examined according to their cervimetric progress during the first stage of labour. A partogram and labour stencil were used to identify dysfunctional labour which was treated with a standard protocol of augmentation by oxytocin. This policy achieved labours with a mean 'observed first stage' of 6.3 h and a caesarean section rate of 8.7%. There was one stillbirth due to multiple congenital abnormalities and no increase in perinatal morbidity. Our data show that the type of first stage cervimetric pattern is helpful in predicting the outcome of labour. A normal cervimetric pattern resulted in a vaginal delivery rate of 98.4%; primary dysfunctional labour, which could be improved by oxytocin, had a 93.8% incidence of vaginal delivery, but if there was no improvement in the rate of cervical dilatation when this was administered the vaginal delivery rate was only 22.7% . A prolonged latent phase was associated with a caesarean section rate of 16.7% and the incidence of neonatal intubation was nearly as high as that found in uncorrected primary dysfunctional labour. The neonatal asphyxia in secondary arrest was minimal with an overall caesarean section rate of 28.4%; there was no increased incidence of neonatal morbidity with this cervimetric type.
通过对连续2000例分娩的研究，根据684例自然临产入院的初产妇在第一产程中的宫颈测量进展情况，对其分娩结局进行了检查。使用产程图和分娩模板来识别功能失调性分娩，并采用标准的缩宫素加强宫缩方案进行治疗。该方案使平均“观察到的第一产程”为6.3小时，剖宫产率为8.7%。有1例因多发先天性异常导致的死产，围产期发病率无增加。我们的数据表明，第一产程宫颈测量模式类型有助于预测分娩结局。正常的宫颈测量模式导致阴道分娩率为98.4%；原发性功能失调性分娩，可通过缩宫素改善，阴道分娩发生率为93.8%，但使用缩宫素后宫颈扩张率无改善时，阴道分娩率仅为22.7%。潜伏期延长与剖宫产率16.7%相关，新生儿插管发生率与未经纠正的原发性功能失调性分娩相近。继发性产程停滞中的新生儿窒息极少，总体剖宫产率为28.4%；这种宫颈测量类型的新生儿发病率没有增加。
