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目的研究新产程标准实施后，产程中剖宫产率、剖宫产指征的变化及母儿预后。方法对2014年8月至10月于首都医科大学附属北京妇产医院按新产程标准阴道试产的3290例孕妇（新产程组），分析产程中中转剖宫产的剖宫产率、剖宫产指征及母儿预后指标，并与2014年5月至7月新产程标准实施前阴道试产的2987例孕妇（原产程组）的产程中中转剖宫产率、剖宫产指征及母儿预后指标进行比较分析。结果新产程组孕妇产程中中转剖宫产率为6.20%（204/3290），明显低于原产程组的8.50%（254/2987），两组比较，差异有统计学意义（χ2=14.40，P<0.01）。原产程组孕妇的剖宫产指征：潜伏期延长18例（7.1%，18/254），活跃期停滞82例（32.3%，82/254），相对头盆不称44例（17.3%，44/254），胎儿窘迫80例（31.5%，80/254），宫内感染23例（9.1%，23/254），社会因素7例（2.8%，7/254）；新产程组分别为：活跃期停滞16.2%（33/204），相对头盆不称34.8%（71/204），胎儿窘迫35.8%（73/204），宫内感染10.8%（22/204），社会因素2.5%（5/204）；两组剖宫产指征存在差异，原产程组中产程时限异常（包括潜伏期延长及活跃期停滞）是剖宫产的首位指征，而胎儿窘迫成为新产程组剖宫产的首位指征。新产程组产程中剖宫产孕妇产后出血的发生率明显高于原产程组[分别为6.9%（14/204）、1.6%（4/254）；χ2=8.38，P<0.05]，两组产程中剖宫产孕妇的产褥病率、新生儿窒息发生率无差异（P>0.05）。结论新产程标准实施后，产程中剖宫产率明显下降，但新产程组产程中剖宫产孕妇产后出血的发生率明显增加，需做好预防工作。

Objective To study the changes of intrapartum cesarean rate, cesarean indications and pregnancy outcomes after the new partogram applied. Methods Totally 3 290 pregnant women trying to vaginal delivery which were managed according to the new partogram in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from August to October in 2014 (new partogram group) were involved;2 987 pregnancy women trying to vaginal delivery from May to July in 2014 which were managed according to the old partogram (old partogram group) were involved as control. The intrapartum cesarean rate, cesarean indications and the pregnancy outcomes between the two groups were analyzed. Results The rate of intrapartum cesarean delivery was 8.50%(254/2 987) in old partogram group, and was significantly higher than that in new partogram group (6.2%, 204/3 290;P<0.01). Cesarean indications in old partogram group included 18 labor protraction (7.1%, 18/254), 82 labor arrest (32.3%, 82/254), 44 relative cephalopelvic disproportion (17.3%, 44/254), 80 fetal distress (31.5%, 80/254), 23 intrauterine infection (9.1%, 23/254) and 7 cesarean delivery on maternal request (CDMR;2.8%, 7/254) . Cesarean indications in new partogram group included 33 labor arrest (16.2%, 33/204), 71 relative cephalopelvic disproportion (34.8%, 71/204), 73 fetal distress (35.8%, 73/204) and 22 intrauterine infection (10.8%, 22/204), 5 CDMR (2.5%, 5/204). There were no significant differences in incidence of asphyxia neonatorum and puerperal morbidity (P>0.05), but the incidence of postpartum hemorrhage in new partogram group was higher than the old&nbsp;partogram group [6.9% (14/204) versus 1.6% (4/254), P<0.05]. Conclusion After the new partogram applied, the rate of intrapartum cesarean delivery is significantly decreased, but the incidence of postpartum hemorrhage is increased.