diff --git a/platform-dal/src/main/java/com/lyms/platform/query/AntExRecordQuery.java b/platform-dal/src/main/java/com/lyms/platform/query/AntExRecordQuery.java
index e4b849e..1d74d1a 100644
--- a/platform-dal/src/main/java/com/lyms/platform/query/AntExRecordQuery.java
+++ b/platform-dal/src/main/java/com/lyms/platform/query/AntExRecordQuery.java
@@ -458,6 +458,10 @@ public class AntExRecordQuery extends BaseQuery implements IConvertToNativeQuery
         if (null != type) {
             condition = condition.and("type", type, MongoOper.IS);
         }
+
+        if (null != first) {
+            condition = condition.and("first", first, MongoOper.IS);
+        }
         if (isFirst != null) {
             condition = condition.and("isFirst", isFirst, MongoOper.IS);
         }
diff --git a/platform-operate-api/src/main/java/com/lyms/platform/operate/web/facade/BabyBookbuildingFacade.java b/platform-operate-api/src/main/java/com/lyms/platform/operate/web/facade/BabyBookbuildingFacade.java
index f6550ec..6821af1 100644
--- a/platform-operate-api/src/main/java/com/lyms/platform/operate/web/facade/BabyBookbuildingFacade.java
+++ b/platform-operate-api/src/main/java/com/lyms/platform/operate/web/facade/BabyBookbuildingFacade.java
@@ -487,6 +487,8 @@ public class BabyBookbuildingFacade {
 
         String hid = autoMatchFacade.getHospitalId(userId);
 
+        boolean isBuildPatient = true;
+
         BaseObjectResponse br = new BaseObjectResponse();
         try {
             //判断儿童是否建档在该医院
@@ -629,6 +631,7 @@ public class BabyBookbuildingFacade {
                                 personService.updatePerson(pm, pm.getId());
                             }
                         } else if (pm.getType() != null && pm.getType() == 3) {
+
                             //儿童建档时 需要修改自动分娩的产妇
                             for (Patients patients1 : pats) {
                                 //自动分娩类型
@@ -643,13 +646,18 @@ public class BabyBookbuildingFacade {
                                             patients2.setFmDate(StringUtils.isEmpty(request.getDueDate()) ? DateUtil.parseYMD(request.getBabyBirthday()) : DateUtil.parseYMD(request.getDueDate()));
                                             patients2.setBuildType(0);
                                             patientsService.updatePatient(patients2);
+
+                                            isBuildPatient = false;
                                         }
                                     }
                                 }
+
+                                patients = patients1;
+
                             }
                         }
 
-                        if (patients == null) {
+                        if (patients == null && isBuildPatient) {
                             //添加产妇建档
                             Patients patient = getPatientsData(request);
                             patient.setPid(pm.getId());
diff --git a/platform-operate-api/src/main/java/com/lyms/platform/operate/web/result/AntexChuResult.java b/platform-operate-api/src/main/java/com/lyms/platform/operate/web/result/AntexChuResult.java
index b2994c1..08a8745 100644
--- a/platform-operate-api/src/main/java/com/lyms/platform/operate/web/result/AntexChuResult.java
+++ b/platform-operate-api/src/main/java/com/lyms/platform/operate/web/result/AntexChuResult.java
@@ -21,7 +21,7 @@ public class AntexChuResult {
 
     private String genRemark; // 一般检查备注
     private String gynRemark; // 妇科检查备注
-
+    private Integer first; // 1否 2 是，是否当前医院第一次初诊 德州需求
 
     //该字段是针对聊城东昌区妇幼保健医院保存当天孕妇的lis检查项
     private String lisCheckItems;
@@ -34,6 +34,13 @@ public class AntexChuResult {
         this.lisCheckItems = lisCheckItems;
     }
 
+    public Integer getFirst() {
+        return first;
+    }
+
+    public void setFirst(Integer first) {
+        this.first = first;
+    }
 
     public String getGenRemark() {
         return genRemark;
@@ -1481,6 +1488,8 @@ public class AntexChuResult {
             setEdema(antExChuModel.getEdema());
             setLisCheckItems(antExChuModel.getLisCheckItems());
 
+            setFirst(antExChuModel.getFirst());
+
         }
         return this;
     }