ABSTRACT
Objective To calculate the standardized cesarean delivery rate by considering the individual characteristics of puerprae, and to evaluate the medical quality of obstetrics in the hospital. Methods Medical records of 69 406 puerprae from January to December in 2016 were collected from 33 tertiary general hospitals in Shanxi province. A logistic regression model was used to construct a maternal risk adjustment model of cesarean delivery, with the area under the ROC curve (AUC) used to evaluate the goodness of fit of the model. Results Of the 69 406 puerprae, 30 881 used caesarean delivery, accounting to 44. 37% . The cesarean section rate difference was statistically significant among those of different age, nationality, conditions upon admission, whether to participate in a clinical pathway, fetus number, birth weight and maternal gestational age, as well as the severity of complications (P< 0. 001). According to the logistic model, those of older age, history of cesarean delivery, twins or triplet births, neonatal overweight, malposition, placenta previa, and those with various pregnancy complications tend to use maternal cesarean section surgery, with a goodness-of-fit of 0. 82. With risk adjusted, the ranking of actual cesarean section rate and standardized cesarean section rate varies among the hospitals. Conclusions With the factor of puerprae factor adjusted, the standardized cesarean delivery rate can eliminate risk factors of the puerprae, it is feasible to scientifically evaluate the cesarean delivery rate of the hospital′s obstetric department.
ABSTRACT
Objective:To explore the influence of new labor standards on the indications in the birth process and the prognosis of mothers and infants.Methods:186 cases treated in our hospital from January,2015 to January,2016 were divided into the observation group (85 cases) and the control group (101 cases),the observation group received new labor standards,the control group adopt Friedman labor standards.The clinical indications,pregnant complications,pregnant outcome,neonatal-perinatal outcome were compared between two groups.Results:The cesarean delivery rate,number of using oxytocin,forceps delivery rate of observation group were significantly lower than those of the control group(P＜0.05);the duration time of both first and second stage of labor were obviously longer than those of the control group (P＜0.05);the duration time of active phase,bleeding volume in birth process in both groups showed no statistical difference (P＞0.05);there was no adverse maternal and infant events in both groups;the incidence rate of pregnancy complications,fetal distress in uterus,asphyxia neonatorum and neonatal body weight were of no statistical difference (P＞0.05).Conclusion:The new labor standards prolong the duration time of birth and give women fully trial opportunities,could effectively reduce the rate of cesarean section,reduce the over intervention production.