在自发劳动过程中评估劳动管理实践
Charlotte Voisin1, Johan Pacelli1, Audrey Fels2
1Maternity of the Hospital Group Paris Saint Joseph, 185 rue Raymond Losserand, Paris 75014, France.
Journal of gynecology obstetrics and human reproduction
|December 31, 2023
概括
法国国家促进生理劳动的指导方针减少了医疗干预. 这导致阴道分娩率增加,产后出血减少,新生儿转移减少,尽管分娩时间较长.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生政策 公共卫生政策
背景情况:
- 2017年,法国国家卫生指南发布,以促进生理劳动和尽量减少医疗干预.
- 这项研究评估了这些指导方针对IIb型围产中心阴道分娩率的影响.
研究的目的:
- 评估国家劳工准则的发布与阴道分娩率之间的关联.
- 评估指导方针的实施,分娩时间,产后出血和新生儿不良结果.
主要方法:
- 一个回顾性,单一的中心,前后研究设计.
- 2016年 (指导方针之前) 和2018年 (指导方针之后) 数据的比较.
- 纳入标准:没有先前剖腹产的妇女,头部呈现的单独胎儿,怀孕37周后的自发分娩;分析按平价分层.
主要成果:
- 催产素的使用率从48%降至35% (P < 0.0001);羊膜切除率从39.5%降至27.7% (P < 0.0001).
- 劳动时间显著增加 (360到390分钟,P < 0.0001),特别是在无产妇妇女 (465到562分钟,P < 0.0001).
- 阴道分娩率增加 (94.6%至96%,P=0.05),产后出血减少 (6%至4.5%,P=0.04),新生儿转移/不良结果减少.
结论:
- 减少积极的分娩干预与更长的分娩时间有关.
- 这种方法与剖腹产分娩,产后出血和新生儿移植率的降低有关.
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