张的指南与1994年世卫组织部分图:在管理妊娠高血压疾病的比较有效性
Cheng-Juan Sun1, Yuanyuan Zheng2, Shaofei Su3
1Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Beijing Maternal and Child Health Care Hospital, Capital Medical University, No. 251 Yaojiayuan Road, Beijing, 100026, China. sunchengjuan@mail.ccmu.edu.cn.
BMC pregnancy and childbirth
|December 9, 2025
概括
张的指导方针减少了剖腹产和高血压怀孕的分娩干预,但增加了产后出血 (PPH) 和子分娩率. 它很好地适应了母亲的晚年和ART怀孕,而不会影响新生儿的结果.
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
- 劳动力管理 劳动力管理
背景情况:
- 现有两种劳动监测协议,即张的指导方针和1994年的世卫组织部分图.
- 张的指导方针在活跃阶段使用6厘米的宫扩张,并强调个性化护理.
- 1994年世界卫生组织的部分图使用了4厘米的扩张和早期干预的标准化行动线.
研究的目的:
- 为了比较张的指导方针和1994年世卫组织关于管理妊娠高血压障碍 (HDP) 的部分图.
- 为了评估两个协议之间的分娩干预,孕产妇年龄差异和产后结果的差异.
主要方法:
- 追溯性队列研究,对5806名HDP无双的女性进行了追溯性队列研究.
- 分层为1994年世卫组织部分图 (N=2100) 和张的指南 (N=3706) 队列.
- 主要终点:产后剖腹产和产后出血 (PPH) 率;次要终点:分娩干预,子分娩和新生儿窒息率.
主要成果:
- 张的指导方针显著降低了产后剖腹产 (10.96%对13.33%) 和分娩干预率 (16.06%对43.62%).
- 张的指导方针增加了PPH (20.02%对11.24%) 和子交付率 (19.67%对7.90%).
- 在张的指南组中观察到更高的晚年孕产妇 (AMA) 和辅助生殖技术 (ART) 怀孕率;新生儿窒息率没有差异.
结论:
- 张的指导方针有效地减少了与1994年世卫组织部分图相比,HDP的产后剖腹产和分娩干预.
- 该指南适应了AMA和ART怀孕,但没有增加新生儿窒息风险.
- 然而,张的指导方针与增加的PPH和子交付有关,该协议本身被确定为独立的PPH风险因素.
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