Effect of duration of second labor stage on maternal-infant transmission of HBV infected pregnant women and maternal-neonatal outcomes after application of new partogram

YIN Ying-hui; WANG Mei

doi:10.3969/j.issn.1007-8134.2017.04.008

Abstract：Objective To investigate the effect of duration of second labor stage on maternal-infant transmission of HBV infected pregnant women and maternal-neonatal outcomes under new partogram.Methods A retrospective analysis was performed on 401 nulliparous single full-term pregnant patients with HBV infection at the Center of Maternal Health of 302 Military Hospital of China from July 1st, 2013 to March 31st , 2016. Among them, 137 patients under the old labor standard (Friedman labor standard) before July 31st in 2016 served as the old-stage group, and 264 patients under the new labor standard after January 1st, 2015 served as the new-stage group. The new-stage group was further divided into 2 groups according to second-stage duration: new second-stage≥2 h group (n=58 cases) and new second-stage<2 h group (n=206 cases). The rates of mother-to-child transmission, delivery mode and complication in mother and infant between the new-stage group and the old-stage group, as well as between the new second-stage≥2 h group and the new second-stage<2 h group were analyzed.Results Whether the new-stage group and the old-stage group, or the new second-stage≥2 h group and the new second-stage<2 h group, the HBsAg was all negative for 7-month-old and 12-month-old infants, the success rate of mother-to-child transmission was 100％. The new-stage group had a significantly higher delivery rate (88.6％) than the old-stage group (78.8％), but lower forceps delivery rate (4.9％) and cesarean rate (6.4％) than the old-stage group (10.2％, 12.4％) (P<0.05). There were no significant differences in the rate of postpartum hemorrhage (13.6％vs. 11.7％), uroschesis (3.4％vs. 2.2％), puerperal infection (12.9％vs. 10.2％) and neonates with asphyxia (1.9％vs. 1.5％), between the new-stage group and the old-stage group. The new second-stage≥2 h group had a higher forceps delivery rate (10.3％vs. 3.4％) and cesarean rate (18.97％vs. 2.91％) than the new second-stage<2 h group (P<0.05). Compared with the new second-stage<2 h group, the new second-stage≥2 h group had higher rates of postpartum hemorrhage (20.7％vs. 11.7％), uroschesis (8.6％vs. 1.9％) and puerperal infection (20.7％vs. 10.7％). The neonatal asphyxia rate showed no significant difference between 2 groups (5.2％vs.1.5％).Conclusions Under new partogram, the prolonged duration of the second labor stage significantly decreases the rate of cesarean section. It does not increase the risk of maternal-infant transmission of HBV and maternal and child complication.