Published online Aug 26, 2020. doi: 10.12998/wjcc.v8.i16.3483
Peer-review started: April 7, 2020
First decision: April 22, 2020
Revised: May 4, 2020
Accepted: July 14, 2020
Article in press: July 14, 2020
Published online: August 26, 2020
Processing time: 140 Days and 6.7 Hours
After China’s two-child policy was fully liberalized, the country officially entered the “universal two-children” era, and the obstetrics industry faced enormous challenges brought about by the birth peak. Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy. The cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet in 2010.
The motivation of this research was to explore how to promote the trial of labor success rate, and determine the feasibility of reducing the rate of conversion to cesarean section.
The research objectives were to summarize the related factors of the failed vaginal delivery, and to propose reasonable prevention and resolution strategies to increase the trial of labor success rate.
A retrospective analysis was performed on 9240 maternal women who met vaginal delivery conditions and required a trial of labor from January 2016 to December 2018 at our hospital. Among them, 8164 pregnant women who had a successful trial of labor were used as a control group, and 1076 pregnant women who had a failed trial of labor and converted to an emergency cesarean section were used as an observation group. The patients’ clinical data during hospitalization were collected for comparative analysis, the related factors of the failed trial of labor were discussed, and reasonable prevention and resolution strategies were proposed to increase the trial of labor success rate.
The analysis revealed that advanced age, macrosomia, delayed pregnancy, use of uterine contraction drugs, primipara, and fever during labor were associated with conversion to emergency cesarean section in failed trial of labor. Multivariate regression analysis showed that age, gestational age, primipara, use of uterine contraction drug, fever during birth, and newborn weight led to a higher probability of conversion to an emergency cesarean section in the failed trial of labor.
The conversion to emergency cesarean section in failed trial of labor is affected by many factors.
The authors will still count the follow-up data and apply for relevant research project funding in the future, and strive for more data by combining with hospitals in different regions and ethnic groups.