关键词: 妇产科学, 难产助产技术, 规范化培训, 个体化指导, 继续医学教育

Abstract: Objective To investigate and analyze the situation of midwifery skills on dystocia among employees from different hospitals and related medical staff in Zhejiang Province. Methods Totally 1 162 in-service staff from 154 hospitals in Zhejiang Province in 2021 joined the project in 2021. Chi-squared test was used to compare the situation of midwifery skills on dystocia from different hospitals. The results were expected to improve the management capacity on dystocia for midwives in these hospitals. Results Among the 154 hospitals, the overall conducting rates of midwifery skills were different, management of shoulder dystocia and forceps operation/fetal head absorption were most likely to be provided by hospitals [with the proportions as 54.5% (84/154), 55.2% (85/154), respectively], and other skills were less provided; and the conducting rate of three midwifery skills were higher in Level-III hospitals than those in Level-II hospitals, including forceps operation/fetal head absorption[68.0%(51/75) vs. 43.9%(29/66)], vaginal delivery of twins[29.3%(22/75)vs. 7.6%(5/66)] and abdominal version for breech presentation [36.0%(27/75) vs.12.1%(8/66)], the differences of were all significant (P<0.05). As for midwives and obstetricians, the mastery rates of different skills varied. However, 26.7%(310/1 162) of them actually do not master any skills. Conclusions The conducting rates of midwifery skills on dystocia were not satisfying among hospitals in Zhejiang Province, and the managing capacity for dystocia of the midwives and obstetricians needs to be improved, the measures should include reasonable resources allocation, supporting first and second-level hospitals, strengthening the standardized training and clinical practice of midwives based on an individualized strategy for midwives with different training experience.

Key words: Obstetrics, Midwifery skills on dystocia, Standardized training, Individualized guidance, Continuing medical education